14-9000

104-10222-10042 | 2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992 |

MATERE Fysiszp AS CIA HEADS ARTES fy

~ ROUSE SELECT COIUTEE OY ASSSSSTIOG LUXS STAEE EE Rees
SECRET

Frur trrue/ymamernoure: Reg tea - Ladlele. €. 2
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ee:

INCLUSIVE DATES: ? so — 'N.

CUSTODIAL UNIT/LOCATION: _ALeice of Personne!
ROM: Fe 13 | ___.

DELETIONS, IF ANY:

ATE
RECEIVED

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ETE RW B98 ss §
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No OSMENTS MAY BE COPTED OR RIMOVED FAM THES TELE

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megan eer et
5 Ten TGS
ARSE Win EON oes 7


14-0000

~ SECRET .
a . FR bea Veiled tn}
Cate retrarta .

“ REQUEST FOR PERSONNEL ACTION 31 ‘July 1973
(hata Feeu~ Middle}

BustoseVidela, Cheetopee i.

4 _emective DATE aPONTETED

. RAMAL Peuesber

007667

2. MATURE CF PERSONNEL ACTION

S$ CATEGORY OF EMPLOYMENT

Reassignment Regular

10, LOCATION OF OFFICIAL STATION

of

DDO/WH Division

FI Staff Washington, D.C.

12. POSITION NUMBER 1). CAMETE SERVICE DEHONATION

1). POSITION Tite .
OPS Officer (af 0640 D
Va CLAMMINCATION SCHEDULE (GN, 1R, et.) 113. OCCUPATIONAL Semmes | 78. Gta ane o1tr 7 SManORMAM

Gs ~ | 9136.01 13.7 + 23642 aaa

1G, REMARKS

Home Base: Wil

alt wort

Toate SIGHEO ~ fi

\ Jul 73 LISA. a Chonan td fo wr

(oat “CA

MES ALPHABETIC

29110 Sido ten ic 0c) an io Poa

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- - ACH ence Ee Yee bald coat Treg uO GA ta EOD DATA | HO NO
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‘cout lad “an (Stale

7. YAH AND NECA 0 MOM AUINORITY (Complesed by Office of
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tr CR ~—treoel HEalin eS CODE |
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14-0000

3

sey

Crone

“ened
EVES CULY 1? Jan 1973

MEMORANDUM FOR: Chairman, GS-13 Evaluation Board

SUBJECT : Recommendation for Promotion to GS-4 -
Charlotte Bustos-Videla

L Itis recommended that Charlotte Bustos-Videla be promoted
from GS-13 to GS-14,

2. The performance of this officer has been characterized for
many years by all of her supervisors as consistently strong to out-
standing, She has been able to establish herself as indispensable in-
each Headquarters Branch or Field Station asd gnment, usually :
functioning as the backbone of the unit to which assigned, Since return
to Headquarters in Scptember 1972 from her field assignment in Mexico,
her performance has been entirely congruent with the thrust of the
Field Station's énthusiasm over her ability, performance, attitude and
growth potential. She is currently chief ofthe Cuban and CA Section
of her branch, and has established once again her mastery over her
assigned duties, She is the kind of sound, dependable, yet
imaginative officer eyreatly appreciated by her supervisors, In
short, she is a true professional who performs beyond her peace level,

8. In regard to her potential, she has served in the Agency
since 1951, starting as a secretary/stenographer , and adyancing
brilliantly with, each new challenge offered, She achieved professional
Status in 1953 and has spent the bulk of her time since then specializing
in Latin American affairs, demonstrating total Hexibility In assignments,
a voracious appetite for work and a penchant for exceptionally precise
and thorough production, A review of her carecr to date can lead to the
conclusion that she has always risen successfully to each new
professional challenge, and is still far from reaching her maximum
capacities, While she has had Little supervisory experience in the
field, her supervisor was of the-ophion that she is a “natural leader",
This has been borne out in her‘perfermance in her current capacity
as a Branch Section Chief, In which she has demonstrated exemplary
supervisory ability, Notwithstanding her drive, aggressiveness and
professional aplomb, she is a popular co-worker, is receptive to guidance
and sensitive and responsive to the needs of her subordinates.

ree

lolar oly ie meme Tr
sctnel Mae ceric

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ted y eee vaccine

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14-00000

LammaeY

ied

ined SECRET

EYES GELy

4, . This employee has utilized her fluency in the Spanish language
to maximum advantage in her work, Formal testing recently confirmed
her high proficiency in that language. Coupled with a comprehensive.
training record and her Invaluable experiences over a twenty year
period, she has become particularly effective in Latin American
operations and operational support, demonstrating excellence in each
of several recognized specializations, including CI operations,
functional support, reports and requirements, area support and varied

covert action activities,

5. The officer's adaptability, high intelligence and mastery over
her trade was of inestimable value to Mexico City Station, and over a
five year period from 1967 to 1972, she functioned as the Station's
internal troubleshooter. Her duties included the maintenance of
watchlists, screening of travel documents, processing of raw
technical take, target analysis, reperts writing, operational support,
handling of outside contract agents, and special assignments as the
Chief of Station's Executive Assistant,

6. The employee is occasionally called upon by the Office of
Training to administer specialized training, and she was chosen
recently ta attend the Mid-Career Course ending in December 1972,
Meanwhile, her absence from her new job {s felt sorely by the
Branch, Df is expected that her current assignment will Last about

two years,

7, Wi summary, we have here an exceptional officer who has
been performing at the level of a GS-l4 for some years; it is now
tinie to promote her te that grade commensurate with her performance

and which she so justly deserves,

“3 pn Q = pb j \y ,
“Tieodore G, Shackley 2
Chief a
Western HemisphereDivision

—
Eras GULy


14-00000

Noe

MEMORANDUM FOR: Chairman, QSI - Honor and Merit Awards Panel

SUBJECT - : Request for Quality Step increase (HR 20-37)
Mrs. Charlotte Bustos-Videla

1. On the basis of the information presunted helow,
1t 1s recommended that a Quality Step Increase be approved
for Charlotte Bustos-Videla.

- 2. As noted in the attached fitnoss report, Subject's
performance of.her duties has been uniformly outstanding.
In addition to her responsibilittos in the Cuban section of
the Mexico City Station, she has recently heen made the exec-
utive assistant to the Chief of Station at Mexico City. In
this job, she screens all incoming material for matters of
interest to the Chief and Deputy Chief of Station. She also
continues performing her past functtons in the Cuban section

for the Station,

3, Subject's present high quality of performance is
typleal of ber performances since she entered the Agency in
195), It is fully expected that this ievel of performance
will be matntained,

4. Although the present Chief of Station was not the
reviewing official on the attached fitness roport, ‘he has
commented that he considered Subject an outstanding officer
and has recommended that she be considered iov a Quality

Step Increase,

Cf iA
Lo ihigeet [, Kh me
William V. Broe
Chief
Western Homisphere Division

OPP

}
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“a>
ae

14-0000

EVES C Only
SECRET

MEMORANTUN FOR: Secretary, CBCB Panel (Section A)

SUBJECT: Recompende+ioa for Promotion to Grade 8-13
Charlotte Z. Bustos-Videla

1. The promotion of Charlotte Z. Bustos-Videla from G8-12 to
GS-13 is hereby recoumended,

2.” This exceptional officer has now been performing at a
senior level for several years and, while recognition through a
Quality Step Increase was granted her last year, her sustained |
perféruance clearly exceeding the requiresents of a GS-13 qualifies
her for a promotion at this time. Subject is one of the outatanding
women vho Nave demonstrated their capacity for even further
advancement within the Agency and will probably continue to advance
in the future. The present recommendation is based on already
demonstrated ability to operate at a senior level.

R. Sifect is Jo yeara old and has bean in grade as a GS-12

for the past five sud one-nal? years,

4 \ G
Boi Decherd
Deszond PitvOsrald
Chief,
Weatera Hemisphere Division

EVES ONLY
SECRET


14-0000

~ ToL CRE -

(When Feird ta}

DAT Paerarto

30 August 1972

, cattoot Of En oretnt
Regular 7
. 6. LEOa AUTMORITY (Compleend by Ose of

Cnasoeanid

19. LOCATION OF onnicnas $1anGe

2. and (Law Frev— Maddie)
Bustosvidela, Cf Z. |

2. MATURE OF PERSOROSR ACNON:
Reassignmont and Transfer to

Vouchered Funds

7, PIMANGIAL ANALYTES MQ.
Lt

DDP/WH Division
Branch 1
CA Section

Wash., D. C.

11 ROURON Ime
Ops Officer
$4, CLASHARCATION SCHEDUAE (G5, 15, ets.)

18. GRADE ANO STrP

7

13 OCCUPATIONAL BEES
0136.01

FROM: DDP/WH/BR 1/MEXICO CITY STATION/0418 om BASE; WH

2 = Securit :
1 - Finance. pa Ascronst Prontad by fice 29/08 Cah 1 7a

7 t coe ,
tssuttirny WZ (Concur: CCS Crt ) OAL £5 SEP

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14-00000

SECRET,

pe gee 79

MEMORANDUM FOR: Charlotte Buatos-Videla
THROUGH : Chief, WH Division
SUBJECT : Quality Step Iecrease

1, 1 was pleased to learn that you have heen

granted a Cuality Step Increase. Such recognition is

proof. of tho high esteem in which you nre held by your
supervisors in the Clandestine Service,
2. Please accept my personal best wishes, I ap

confident that your future performance will be of a

eontinuing high quality.

mon . : -¢
epotee eg ee!

Thomas H, Karenossires
Veputy Director for Pians

rT ar }
aA Ape ays
eRe poo + mrs
Be tb ede ; = ad

{ a 7


14-0000

SECRET

“=~

12 DEC 1969

MEMORANDUM FOR: Head, Clandestine Service
Career Service

SUBJECT : Notification of Approval of
: Quality Step Increase - -
Charlotte bustos-Videla

1. Lam pleased to send to you tho attached official
notification of the approval ofa second Quality Step Increase
to be awarded to thia employee. The previous Quality Step
Increase wan effective March 1964.

2. May Caygain ask that you arrange an appropriate
ceremony for the presentation of this Quality ‘Step Increase

which is in recognition of her continuing excellent performance.

f Nerd ¥ SSSA ES meee

f Kobert 3, Whttles
Director of Pe raonnel

- ae m™

wae fe cet a2

~ S b (; RET errle wa
hsserceplilbaood

tee na ee

14-0000

+

Beene

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SUBJECT:

=“!
CoAT
Paste Pee

-2-

Request for Quality Step Increase (HR 20-37)

Mrs. Charlotte Bustos-Videla

APPROVAL RECOMMENDED:

12> Doc Y4UI

14-0000 ‘

: _— SECRET a

FM hea belted bey

Dale PHPAttS
bad sirery EAN oc - . vache
REQUEST FOR PERSONNEL ACTION 17 OCTOBER 1968
1 Stat NUMeEE amt Lait ber Mddle,
_ L ‘ M 3. _*
007667 BUSTOS-VIDELA, CSSiEmSEE Z,
3 NATURE OF PLESONNEL ACTION @_Erectivt Dart Bequestig 5 CAIEGORY OF EaNOTAENt
. : mest bar vias
REASSIGNNENT 11 | 93 REGULAR
‘ ~ || 7 FINANCIAL ANALYSIS MO [@ LEGAL AUTHORITY (Completed by Diffie of
. 4 PUNOS » ChARGLAKE Pevcmnet }
“ [Jour [x ]owo | 9108 000 |
9 ORQANIZATIONAL Gf 2ONANONS 10. LOCATION OF GFFICIAL STANON
DDP/WH
. FOREIGN FIELD .
i BRANCH 1 ‘ . °
; MEXICO CITY, MEXICO STATION MEXICO CITY, . MEXICO
VE. POSITION fing 12 POSITION NUMBER 33 CAREER SERVICE DESIONATION
OPS OFFICER 3) 0413 D
Pe ciassuncatices SCHEORE (GE TAL ete) 1S CLO *Aroriat sEmes [16 GRADE AND STEP 17 SALARY O8 RATE
an Gs 0136.01 13 4 5 15849 7
19 REMARKS ; rs
u
. starr EMPLOYEE SPECIAL .
. FROM: POSTION # 1528
; ON LL
Y O4fl HOD 18S SHAT uF CaRten § sernct ‘SPrROV: NG Pret!
1 Hen ry L. Bertiold; we | .

bez) h ié ak, a
eect timed mate,
. SPACE Show O08 EXCLUSIVE USsi oF THE OFFCy OF PERSONAL . _

-C/Wi Personnel = /

3 ganar fn” Ot tio a Stee a wits Ti rates Ty ;
es ie Pg aonaaeg |] et (cot tot gp AP os. joes
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14-0000

“ SECRET
+ . - 19 dew Filled bad
7 Cath pwe2aeto
\ REQUEST FOR PERSONNEL ACTION 13 OCTORER 1967

Vo Setuky NUnte 2 NAME CT te Fer Medley

07667 4 BUSTOSSVIDELA , cursors 8 Lan 2 PED.

3 NaTuRt re) PRRSONTAL ACTION a uncuv'part Mts TID

> CattGGr? OF EMPOTAINT

REGULAR*

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Vorwaud)

monte

i REASSIGNMENT a. ee |

: pe fee aa
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Pi Joo ——[alowe |. 2198 0000

10 LOCATION OF OFFICIAL STATICS

@ ORDANATIONAL DESIGNATIONS ~

DDP/WH
(| FOREIGN FIELD
21 BRANCH 1
S| MEXICO CITY, MEXICO STATION _MEXICO CITY, MEXICO
‘ . Ub POSITION IT 2 POMTION IN NUMBER LF) cane wait Otsecrea tion
OPS OFFICER _ 1528 D _
1a CLASSINCATION SCHEDULE (GN, EAL rte.) 13. OCCUPATIONAL BERES [18 GRADE AND S117 17 Balaey 08 #ate
Gs 0136.01 _4x122 | 3 13,769
YO REMARKS . *

OPS OFFICER OCCUPYING INTEL ANALYST.
. o ay an
Yo STAFF EMPLOYEE XKE& SPECIAL, wre . aos
pS ¢ yy
free Mi éay heer
ONASY Cy ert LA anck

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C/Wil/Personnel
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14-0000

23 June 1967

sa ne heed

HELVEANDUM FOR: Central Covers Group

Syussac? - 3 Cover for Charlotte 2, Sustos-Vidcla

1. Neva. Charlotte 2, Bustos-Vidola as being tranufersed
PS to Koxico City in starf capacity. She will £111 slot
1523, : , . .

2.0 Urs. Custos-Vidola is travelins undexs Travel Order
No. $9465. (See copy attached) Mor coves will Go that of
n Cependent wife entering Meuico on the Yisitente visa of
hos wha, 22. Cosivr Tastou-Videla, whs is receiving a.
Vastitante viss da connection with a tecching cantrset he has

with the Lag Améviens Univeruaty, © ere)
Mniaworsity da payin for the travel wutos-Videla
oniy anc for all documentation, Who Uni sity alco wiil
ive no quarters of quarteyss allowance. Under the
Looxceoyr Meg. Dustos-Videla will reesive mileare and
¢ gesdiea fer the tein to Mexico City. Linited
aald effeets wilh be sent, the vecsinins iteas (also

1 3
) will bo stored at Covornneat expense,

Bee Leo hu

os ae fet ae cad atte!
ae PreOe SVLCNOI Sa COv an
. sassye

maphoymené Wath the U.

4 wey Tas
3. Jotuativ, Uys.
Status as a Siasa Saploey

3, Due te the cha de, A is requested
they SCG ye tahe anpres Sant the cainvy
ssceedived tovourh 15 Jui yin Arne bo,
ang that effactive 15 ¥ Oo tax no loayer
nt and ALb ot covered by a
LOL yement of soveynnent

nedsuc tions
3 ho.

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SSELQCUT ERT Rieter reser meee

14-0000

. MEXICO CITY, MEXICO STATION MEXICO CITY, MEXICO

- SECRET

CW Rew biditd bad
OATE peteaRtD ‘
REQUEST OR PERSONNEL ACTION | 10 JULY 1967 iN

y Samay ump 2 eae bat =f ret Middle)
007667 BUSTOS | YVIDELA, CHARLOTTE a. ‘
D Naruer oF PrESCNNEL ACT — «_UIHtCTIvE DATE EGAASTIO [5 CATEOORY OF EMMOTMENT
RE ASSIGNMENT AND TRANSFER TO monte vine
CONFIDENTIAL FUNDS 07 REGULAR
7 VietaNCial aMALTSMS © UGm aUIMORItY (Completed by Office of
NO, Cancdaced Perwand)

¢ ORGANIZATIONAL OTRONATIONS To. “TOCATION OF OF o ry STATION
G DDP/WH
FOREIGN FIELD
fl] BRANCH 1

“TTY POSTON Numees 12 CARTER SEAVICE OLSIGNATION

11, POSINION nTue
OPS OFFICER UD | asee |
V3 CCL PA TONAL SERS. 19 GRADE AMD $499 eo" '? SacaRY OW RATE
a a“ _ _
<a __ 0136.01 13 3 $13,769
eS oF fice? oCMP TIAL FE, Ended Menke £7 Pasi tio

Ke OP,
at DDP/WH/1/Pos, No, 1201
PRA IN ACCORDANCE WITH HR20-17d Cb) , NOT TO EXCEED TWO YEARS,

(2 Finagee —
ep ete ae cre ee ee ae ne ee eee

180 Wea y nny g aa aT he ita pena Yea Sana tone 6 CaS TEEVAE APPROVING GHFICET Walt Gla
Wit heraolin le br, y 2
taal LL ite Yh

Robert D. Cashman pup “a
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ire aciaw |* yarios u ort, togray . af stele {3 te it ORG DS Pas “4 ae it te GAEE GF int ty .
Numede aapnacenc | Ud 4008 Ln rr errs Pai OBA we | Wo oa ma
Sere 2 yy |

£2626 | bot lege)s

ara hag HUH eal ESE

AS, Ij
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(2o Ehadd od Mted wOad Sane) FLARES; tL | t j i H i

as ps moi CONTEC: featcancn Ma OF amiga aim APPLOVED

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WOT NSD ust eeevces reron ; SECRET ™

14-0000

CETER,

om Protea
1 DATE PECraMeD
REQUEST FOR PERSONNEL ACTION 19 OCTOBER 1966

TNA | Last Fert— Media)

f
BUSTOSVIDELA, C.Z.
2 MATURE OF PERSONNEL ACTION |
: oar” vead

, meat
PROMOTION . . 10 23 [66
pL ake [Pee ean
o ApoE a -
| fem | fewe | __7235 0620

$ CATEGORY OF EMPLOYMENT

REGULAR

@ LEGAL.AUIMORITY (Complered by Ofie of
Prrmneel) na m

4. CEEQTIVE Date RRQUESTIO

10. LOCATION OF OFFICIAL STATION

9, ORGANIZATIONAL DESIGNATIONS
DDP/WH
BRANCH 1 —_ Ft
FI SECTION ? WASHINGTON, D.C,
V1 Potion File [12 POSITION reumoee T19) CAREER SERVICE DESIGNATION
_ —
_OPS OFFICER (13) 12017 de _D

17 SALARY Of RATE ,

A

0136.01 - 1303-7" $ 13,769 ——~

TS OccuraniOnal seaus [16 Geave ano sit

Gs

10. 9LMARKS .
FROM: GS-12/6 ($12,822)

A
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5h pe

184. BGT THRE OP Ee OFFAL Pate SGNeo

Matas, tw. ok :
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Robert Db, Cashman C/Wi ES

‘0 Shana TURE, , CAaitR SaVAKE APE ROW INR OHTA

eee eee _ SPACE BLOW FOR EXCLUSIVE U cece neue enue
w icine | mM Garon {9 CHALE coving TD STUN TD ACRE __ SME OF itt
wat cone tee meres coat ie >. . . . . OA oy
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dade ie ati tatlt
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es T52 ust etevoes damon SECRET

cry

14.90000

, , , ASEP 1965

MEMORANDUM FOR: CSP8/A

SUBJECT : Recommendation for Promotion of
‘ Charlotte Bustos-Videla

1... The promotion recommendation to GS-13 of Mrs,
Charlotte Bustos-Videla is herchy submitted, Mrs. Bustos-
Videla entered tho Agency in August 1951 as a G8-5 and
rapidly and desorvedly rose to a GS-12 by 1959, She has
now been almost seven years in grade and has been recom=
monded for promotion to the SPS/8 by WH Division five

timos previously.

2. This outstanding officer has continued to per-
form at tho exceptional level which has by now hecome her
standard of porformance, Her past four annual Pitneas
Roports have cach given her an overall rating of outstanding.
In this connection it is noteworthy that no two Fitness Re~-
ports wore written by the same rating officer, She con-
tinues to occupy a GS-12 officer slot and her performance
cloarly continues to exeeed the requirements for that
postition, Shea ds congic dig be one of the sutstanding
women who havo demonstrated thouiv capacity for Lurtner
advancement within the Agency. :

3.. Mrs, Bustos-Videla sot only continues to bring
continuity to the Mexican Branch through her long experience
on Mexican affairs, but consistently contributes to the
smooth functioning of the Branch through her highly cffLicient
organizational capabtlities., She hag been called upon to
handla all manner of difZicuilt desk probtems, She invariably
responds quickly, cheerfully, and effectively. She has been
instrumental in on-the-ich training of a number of officers,
both for desk assignmenze and in preparation for field assign—
ments. She has excellest rapport with innumerable persons in
other areas and staffs, thus adding to the efficiency and
speed with which she aceseplishes her daily tasks, er pro~-
motlon at this time is urged. .

a ad , we
| A ee re
a
ia ney
rn

eS barct | William Y. Broe

fe
welh.

EN Chief,
Western Hemisphere Division


14-0000

SECRET
(When Filled In) 31 Auguot 1966
MEMORANDUM FOR; Gharlotb de BustoseVi tela “a.
THROUGH : Head of @ career Service
SUBJECT : Notification of Non-eligibility for Deslgnation as a

Participant in the CIA Retirement and Disability System

1, AS you may know, we are in the process of reviewing the employment
history and current career-field of all employces in the Agency ta identify
those who are cligible for designation as a participant in the new CIA
Retirement and Disability System, In thir process, the initial review of
each case is made by the individual's Career Service, If the Head of his
Career Service nominates him for participation in the System, this nomina-
tion is reviewed by the CIA Retirement Board which recommends final action
to me. However, if the Head of the Career Service advises that the employee
docs not meet the basic requirements of HR 20-50 for participation, I have
accepted this finding without further review by the CIA Retirement Board.
This practice has been adopted in the Interest of expediting this screening
process so that those employees who are clipible ta partici{pate in the Sya-
tem may be designated partics{pants as soon an possible,

2. Im your case, ‘the Head of your Career Service has advised me that
you do not meet the requirements of HR 20-50 for designation as a partict-
pant and 1 have accordingly made the formal determfnation required by the
regulacion that you are not elfgible for designation. From a review of your
record it appears that the decision of your Carcer Secvice was bascd upon
the face that you do not have sufficient time prior to completing 15 yeara
ot service with the Agency in which you could complete a minimun of 60 months
of qualifying service as required by regulatton. My determ{natlon that you
are pet ctisible at this €fine for designation ino ne vay affects your current
status under the Civil Service detivement System, nor docs fl preclude reson
sideration of your eligibl itty to partleipate in the CLA System Lt you shuld
moet the requirements for designation in the Cuture.

3, Should you destre further tnformatien concerning the requbeements
for designation as a partfefpant in che CfA Retirement System, T suggest that
you read paragraph « of HR 20-50 and paragraph 5 of the Pmployce Bubletin
dated JO Faly t965, entitled "public Lav 8-643, The Central Intell lpeace
Agency Retirement Act of 1964 for Certain Umployecs."

4. Tt is always possible that the records upon which the determination
made in your case may have been tncompleate or {nacenrate regarding your actual
emp toyment histery with the Agency. If, afler studying the materials eited
above, you have questions regarding the determination that you are noc eligh-
ble co participate in the CIA Retirement System, please foul free to contact
officials of your Carcer Service. They are tumfliar with che detatls of your
Case and will aladly discuss thes with you, fa addiction, vou may wish ta dfa-
cuss your case with the CIA Retirement Staff located tn Roow 205, Mayusine
Buiiding (extensivn 2847). if sueh discussions do net resolve any questions
you have regacting your eligibility, you may request that your case be torwualiy
considered by che CLA Rettrement Board, However, this request auat be made

within 30 days of the date of this memorandum,
GP
Ee

co oD CLA netae
Fasten ee
Director of Personnel avempe tg and
LL Area ree

SECRET

a

14-0000

‘

1 MAR 1266

MEMORANDUM FOR: - Secretary, CS/CS Panel (Section A) ra

SUBJECT : Rocomnondation for Promotion to .
Grade GS- 713, Charlotte Z, Bustos-Videla

' 1. The promotion request from GS-12 to GS-13 on
Mrs. Budps-Videla is hereby submitted.

2. This outstanding officer has continued to
perform at the exceptional level which has by now
becomo for her a standard of porformance. She now
formally occupies a senior (GS-13) FI Officer slot in
the Mexican Branch and her performance clearly continues
to exceed the requirement for that position. She is
: still considered to be ono of the outstanding women who

have domonstrated their capacity for further advancement
within the Agency, independently, of the experience on
Mexican affairs acquired through continuity in her :
present assignment.

jf _ 3, The comments mado in connection with the four
: Y previous promotion recommendations continue to be
. entiroly applicable,

4. Sub fect is 37 years old and has been tn grade
ae uv GS-L2 for the pust Six years,

: , 4 -
f Oc retome
fatittion V. Broe
Chief,

Wostorn Womisphere Division


14-00000

eo meeeay
Lise Viabl
SENET

Q «Fe ‘S65

.

MEMORANDUM FOR: Secretary, CS/CS Panel (Section A)

SUBJECT : Recommendation for Promotion to
Grade GS-13, Charlotte Z. Bustos-Videla

1. The promotion request from GS-12 to GS-13 on
Mrs, Bustos-Videla is hereby resubmitted. :

2. This outstanding officer has continued to
perform at the exceptional level which has by now
become for her a standard of performance, Sho now
formally occupies a senior (GS-13) FI Officer slot in
the Mexican Branch and her performance clearly continues
to exceed the requirement for that position. She is
still considered to be one of the outstanding women who
have demonstrated their capacity for further advancement
within the Agency, independently of the exportise on .
Mexican affairs acquired through continuity in her
present assignment.

3, The comments made in connection with the
three previous promotion recommendations continue to
be entirely applicable.

“ke Sabrect 1s 36 years old and has been in grade
as a GS-12 for the past six years.

o . Up FB
Day Rebel ere ae
William V. Broe
Chiet,
Western Hemisphere Divéion


14-000004
3

SECRET

18 dem Belted ded

DATE PeRPARLO

REQUEST FOR PERSONNEL ACTION . as JULY 1965

1 S$6Wa, tt 2 MAME Mata irtn Mastelley
007667 “ | BUSTOS-YIDELA, | Ciepcaec ea fe
; 3 CATEGORY OF EMMOTMENT

3 meatlRe CP PL ESONNEL ACTON

REGULAR

GO LIGAL AUTHORITY (Complried by Ofay of
Penounct >

[GNMEN'

§235_0620

$0 LOCATION OF OFFICIAL STATION

WASHINGTON, D.C.

12 CAREER SERVICE OLSIGNATION

1) posites tre

12. POSITION NUMBER

2s es ee)

PS OFFICER . ——_- --—-- -
13 CORK CUPATIONAL SERIES 16 GRADE AND STOR

17 SALARY O@ RATE —

s-hyars 1/6 70

14 CLASGIMNTALION SCHEDULE (G9. FR, en.)

0136.01 12 45

18 Pease

PROM: DDP/WI/MEXICO SECTION/1202/

YRS, BUSTOS-VIDELA WILL REPLACE Mit. RICHARD SCUTT WHO WILL BE

REASSIGNED TO DDP/EE. a
TO BE EFFECTIVE 1 AUGUST 1965 [ieoos 4 el

i- Security - }

rae Oe ai aie te core “e. DATE SIGNED Ties sxariarunt OF Cantha Seavick BAKO
oF be CASINE AN | | Be ded MAR
’ me

SPACE BELLOW FOR EACLUSIVE USE OF Ht OFFICE OF pias NMEA ate 44 i
NE BE ee pid le sa an aa
ir sation Us, EEG ate a woatES hay Date aa a Tore \ a as ot LE
_ i" i OA Mek. ——
wrt (OBE (008 “0. ua { is pa. “

len aN Shee Rae tute f a | al al. Le a ret i rae

CE Cs) Vyi ePRaATiON | [22 eatin “ORELGHICN GAR aan
- a HET TaENCE {rm ~ fe ma mnt bo I vars : EOD Dara | | 7)
Qe [ |

Je HR
bt ti ul Mace coe? Salt Hn CaREED CUEGORT »” de Naa ieee 40 yocat =e 10
‘Oo ta. re (it ee Tone coud | a— bed mEaii ins, CODE —
t meu is? | tes i
ee a a
'@ tua oi fa a5 CATA fee
fa cans [rom acum

ean Pina ' cont town aia

CA wD SEM 2 MOTI tees { oT
# ane a 1-0 H |
- 25 ts 1 . 4 wood co 4
oo ween Ee ee ee pee eee a gee hs

rere on Cont, epic ancn” 1S OP Arewoval

fae
ae POLLS

LE

SOP GE wes pereous tetow SECRET

'


14-0000

4 SEP 1964

‘

: MEMORANDUM FOR: Secretary, CSCS (Panel A) -

SUBJECT ¢ Recommendation for Promotion to GS-13
Mrs. Charlotte Bustos-Videla. — :

r

1, The promotion to. GS-13 of Mrs, Charlotte Bustos-Videla
is recommended. Mrs. Rustos-Videla entered the Agency in
August 1951 as a GS-5 and rapidly and deservedly rosa to a

GS-12 grado by 1959,

2. This recommendation is based on Mrs. RBustos-Videla's
performance during the past three years as the senior ussist-
ant to the various chiefs of the Mexican desk/branch, who ,
unanimously have found her to be extremely competcnt and ree
liable both in her routine assignments and special tasks
occasionally levied on her, such as country studies, compila-
tion ‘of programs, requirement reviews, etc, .

3, Mrs, Bustes-Videds has consisteithy responded with
intelligence and clarity and bas materially centributed to
orderly imaginative administration of Headquarters support to
: ad most active station. In the -precess, she has been instru-
rental in training on-the-job innumerable officers both for

: desk assiynments and in preparation for field assignments.

} 4, for her outstanding performance she received a quality
. step tncreate in April 1964, This deserved recognition should

now be followed un at this time by a promotion to the next
grade in accordance with the consistently sood performance at
the GS-13 level over a prolonged period ef time,

5 a t ate
Rasa G
Noe RG a aS
Desmond FitsCerald
Chief
Western Hemisphero Divisioa

Ved


14-0000

SEENES

~ CONFIDENTIAL

_ 14 APR 4964

MEMORANDUM FOR: Head, Clandestine Services Career Service

SUBJECT : Notification of Approval of Quality Step Increase «
Mrs. Charlotte Bustos-Videla Los

1. Iam pleased to send to you the attached official notification
of the approval of the Quality Step Increase which you recommended ©

for this employee,

2. The salary increase accomplished by the award of a Quality.
Step Increaso is important and tangible evidence of the esteem in
which the employee so recognized is held, However, I believe the
commendatory and incentive benofits of this award will be partially
lost unless it is presented in an appropriate ceremony which will
afford the individual recognition among co-workers and supervisory
officials, “Also, believe such recognition sorves to inspire other

guployeas ta aspire to Hata BUCH Paco ation,

3, May Tank, tiereforo, that you arrange to have this Quality
Step Incevaso presented at an appropriate ceremony,

fo Kp
d : ‘eb
ease Mell

tt D, Echols”
/ Director of Porsadnel
a


14-0000

SECRET

20 March 1964 :

PESTELNDUM FOR: DDP/OP . :
Tex. DICH : Chief, Clandeotine Services Personnel Office \

DU hed 2 Charlotte 2. Bur
a ¥ , Quality Step Increase

oaVidelg -~ Seen wat for

2. It is recommended that a Quality a tes inerease for
Fee. Charlotte 2. Bustos-Videla he endorsed ty pou for the reasons
nved in the attached memorandum prepa: cared he the Chief, Western

Eenlsphere Division. .

2. A review of Mrs. Bustos i-Videla's AfNiciad Personnel File

Sole St ee WIth

sol : .
hag haer euiifled by v
and “Outstanding.” [ikewlse, ne
by the Uffice of Personnel cont:
imrestive record made by Mrs. Bugtos-Videla.

ne te the
gies ude offiesrta work i
wo the Larch flewals of fl
weed ef bat threa of
(ag wel pee vision of th

CIA approximate!

1982 became

ne enemas onary
PHART I: eae
8 oh isha: 5 aersce
Vaid, Ef he tne St
Fe Ne

See


14-0000

wleacd

6 March 1964

MEMORANDUM FOR: Deputy Director of Plans

ATTENTION : DDP/oP

SUBJECT : Request for Quality Step Increase for
Charlotte Bustos-Videla ;

1, On the basis of the information presented below,
it 18 recommended that a quality step increase be
approvod for Charlotte Bustos-Videla.

2. As stated in the accompanying Fitness Report,
Subject's performance of her duties has been uniformly
outstanding. In addition to her responsibilities as the
desk officer for Mexico ¥I and Operational Support Projects,
she carries a heavy burden in the areas of adwinistration,
preparation of special reports and training of personnel,
Bhe frequently representa the Wexico Section fn dealings
avith other elements of the 4 cy and aete far - Onjeek
ef Section in his aboence, Uvject’s perfrorse ehearly
exceeds the norwal reqitiresents ef the asaAignment anu of
her presunt GS grade level. -

3. Subject's present high quality of performance

typifgics her performance over 4 period of several years
aad it is fully expected that this level will be satutsainod,

4, Consideration was ylven to the granting of a
Merit Award but the quality. Step increase sens morg
appropriate in this casq. Subject nas been papsed over

fer promotion tn the pant, and duoc to limitations as to


14-0000

Wherein st

Sn tee emt we Ak

‘area of assignment, tt is unlikely that a promotion to
grade GS-13 can be obtained, The salary increase is
therefore thought to be the most fitting reward for her
outstanding service.

CONCUR:
IES MO, Mleetee

BOR "Tate

APPROVE:

lA
| _ OM, PY MARCY

i -$5 eator I pee “HOnnel ~“~Hate


14-0000

. SECRET
CBhom Kiiled tay .
CATE Pacrasto

& REQUEST FOR PERSONNEL ACTION
eee ~LS_November_1962_...
1. SUTROAL NUMBER 2. maur fLast-Picet. middie)
7 007667 _~ BLSTOSVIDELA,_C = —-
a. CHUL Tif COTE MEQUCSIED, 4. Category oF CePL Ovetar

3. MATURE OF PEMBONNEL acTIED

wore bow veae
InEASSTGXVEN The 163 GULAE
a Ce a Ee y, COST CARTER WO. Crancts [@. LEGAL auTnoRnITy (Completed by
¢. FUNDS > ane Office of Persennel,
cr to
- 4225..1600_100¢

S. ORCANMDTATIOMAL OERIGNAT OWS 10. LOCATIZ@ OF OFFICIAL STATION

DDP WI .
BRANCIL 3 .
MEXICO SECTION WASHINGTON, D. C,

$3. CAREER staviCt OtSiGenTs ON

58. POSTTEOM TITLE 12. POSITICE ay

OVS OFEICER 0 _ PaaS 15 ES )

14, CLASSIFICATION SCHEOULE CGS, £m, ete, 1 46. OfLMATIONAL SERIES [16. Geant sed STEP

}GS_ ae OLEH OL. 1Z

18. ALMARKS

FROM: = DDP AI /3/607/sexico See/lys

ds reer!
“ws Ge i 1

Tne eee ne sane got
ba feng ”~ Cabicw seaeace apPRaving [a pate de user

oo eat 7 4 aefict

Ra fete rae se
ap ane see
srt aa oe asee
arnas oe arte

 Peeet tes Caetam fears

H
a
{
t
Hl

CAR.

14-0000

aot waka

SORE.

we gay wee een beeen eee,

15 March 1963

MEMORANDUM FOR: Secretary, €8/C8 Panel (Secticn A)

SUBJECT: Recommendation for Pronotion to Grade GB-13
Mes. Charlotte Bustos-Videla

i. Mrs. Charlott2 Bustos-Yidela entered on duty vith WH
Division in August of 1951. She has served on a variety of
desks covering South American a9 well as Mexican and Ceatral
American affairs. In each of her assigmeents ashe has demonstrated
exceptional competence and devotion tu duty.

2. Since December 1957 Kau. Bustos has been assigned to
the Mextoan Desk and at present ia Acting Gilef. She is the
soul and motor of that desk, managing many of its oparntions and
guparvising its sterf, many of wham sha haa trained. Sho is
psst mistress of administraties preied aed nh at :

whic ehe onal oleaen
neteasary do whise peal tng tha aust enmplicatc’d cyperational
eapecta of prejects Is yhoncetnal. Her work autput ia enormcus
and yet everything is dena sinply and modestly with a minimun of
axcaaa moti. She 4a an outatanding eeployse and ahould bo
deserving of reciguition.

3. Is da yecommended that Nra. Buaten be praxoted to
grade 68-13.

J. &, Xtna
Chier,
Hestora Eaaiaphery Division

* ‘ o . \ 7
SG a“ cay? Vite

ody th
wee

14-00000

. SECRET
amen - 7 LMhen Fitted tn)
. CATE PREPARED
REQUEST FOR PERSONNEL ACTION
1 June 1961

$. SCRIAL NuMgeR 2. maur (Last-Fivet-middley
,

f :
107667 BUSTOS-VIDEIA, C. Cc. 2 ‘ ae : :
3 CATEGORY OF CuPLOYMENT

2. mature OF PERSONNEL ACT I Oty 4a. tfrective DATE et quester 3.
nae
“ if
ob |e [é- REGULAR .

HAME CHANGE FROM-CHARLOITZ L, Zed
7.,COST CENTER NO. CHaRce> |e. Lecat auTHoR ITY (Completed by

. v Tov vito cr.
6. FUNDS lx | * “ane (Office of Personnel)
Depa tw | |

9. ORGANIZATIONAL DESIGNATIONS $0. LOCATION OF OFFICIAL STATION

DOP WA
BRANCH 3
MEXICO SECTION

womre oa veae

WASH., D. O,

- 12. POSITION NuMOTR 124 PCR CONTROL WO.E 23 CAREFR SERVICE
BE SIGHATEON

OPS OFFICER D BA-607 4

12. SALAQY OR RATE

49. Position TITLE

Th5. occurariowac SERIES (16. GRADE AND oTer

0136.01 2 be * S955- 92747

$4. CLASSIFICATION SCHEDULE (63, LI, ofe.7

ag 12

ts, SEMARKS

By Marriage,

a a

FEt 1CF APPROVING GrF ict

jy '420 StGmatuwe oF es

Yee. SisShaTuRT of eFaou. 4 i

Pb UF FIC

Leos mm)

a ane ee

Fat yrles

+c obs A adavar te
veg BZ TN


14.90000

od

we
oO
Pat
a
a

2° “tay 1961

MEMORALTUY FOR: WH/Personnel
SURJECT: Change of Name

It is requested that all records in the Arency,
including tha gecbien wnich issnea payroll chock., ba chanj,od
to.raflect sy married name: Charlotte Z, Pustoss/idelas

This chanpa is effective immediatoly.

“1 w ? >
_ an
C4 a cde die hes shee kets ha
uhovlotte 2, Oat s-7idela
KA/3/texheo

WeLrsrmmer cemtsrncren rere

14-0000

} tame

. Wkuotod ; ‘
; _ REQUEST FOR PERSONNEL ACTION \
1. veal Kio, &. Nome (Last-First- Middle) Je - 20K o. £3 -tO0
Mo. | Da. | Ye. ee icode i Mg] Oo. | Yr.
b 07667 ZEHRUNG CHARLOTTE. ort 12| 29 1607 | 08 L2t 51
7 _ G, CST Roem. (9. CSC Ge Other Legal Authority [10 Apat Alfiday.[ 71, FEGUT | 18. D CES ee
Mo. | ba. | Yt. | ¥e3-1 | Code! , Mo. | Da. | Ye. |y¥op1 [Code Do. | vr. «3 [Code
O% loz [51 |No-@1°1 | 50 USCA 403 v No-2 27/51 Nola [2
PREVIOUS ASSIGNMENT
14. Organizational Detignations Code | 15, Location Of Officio! Station Station Code
DOP WH
RANCH 111
\ MEXICO SECTION 4613 |WASH., DO. C, 75033
‘ 16, Dope. - Fi 17, Bositton Title 18. Position No, 19 Serv. 20. Occup. Sories
a
fign «12 AXKXAXRMX OPS OVER i BAR I21 S| 0436. 51
“1, Orode # Stop (22. Salary Or Rate [93. SD 24, 4 Bate OF Grade 95. 5. PST ia ) | 25 Appropriation Number
$ 27 5a ‘Mo. Da. Mo, Da.” Yr, | 0235~1000-2000
112% Sine 9530. ol 0% {40 155, o4 (0S 155 1h aeop eg
. ACTION
U7, Mature OF Action (28. Elf, Dato £99. Type Of Cnployee Code} 30. Separutica Data
Mo. Da. Yr.
PROMOTION 2 ne RUGULAR
e131 4
RESENT ASSIGNMENT ?
fom Cade E62” Locman Ct Orion pation eC

i

| .
1
me
ue? P
. ee es in an a
a8 “Ta “fesdon Pika 437 Botion UN a ff 36. Sarl 37. Coup. Senses
vole & 0,
2 OFS OFGR Akt gs 0136.01
; de 2 ep! 3, Salary Or Pag 40, ee Of Giada (47, PS. __ [a “Aégropriction Manber” ~
$ a
- |
[ Ae nee ~ 2330 LDL hone
fA . Pen: wi hy @ a ‘ame Api Rafedyea ay a ” fo OUEST By 8:
tor ota fe
P.O, Bowerg  Yi'P Pefuoakol Ui te ae ve
‘ ga Call (Name & Telephone Cat.)

ee EE Ae

Vara 's, 1152 ernnny
- wh.

tt


14-0000

Sit 1
~ SIS a
16 July 1959
Pa f- ™ ‘, ay ¢/ 4
fotcdta. fa adiite - 2

-MENORANDUM FOR: Secretary, CS/CS Panel (Section B) '

SUBJECT: Recoumenisation for Promotion «
‘Nisa Charlotte L. Zehrung

1. Miss Charlotte L. Zehrung entered on duty with CIA on 27 August 1951.
— She waa asoigned to the Mextcan Section of WH Divivion, Brauch III, in June
Ye, " 1957. During the past two years she hag been the responsible Case Officer
.. fo several FI and CB Projects,

“ .°2, Miss Zehrung is a loysl and dedicated employee. She has displayed

, considerable initiative and has been able to carry out her duties with a
minigun amount of support. Ste readily accepts responsibility and is a high-
ly offictent worker who thinks clearly and logically, Her knowledge of Head-
quarters and Fiald proexiures in addition to her ability to organize her
work greatly facllitates the smooth functioning of tho Mexican Desk, She
hae denomotrated a superios cosprcheasion of tha numerous and varied projects
of the itexico Clty Station « nt to tha ovceelh Readout rg
support of the stations pevtommanco. Beesvee of her gouud understandiag of

- operationa and her outstamling capacity for work, Miss Zehrung has an excel~
° dent potential for Aséiciihg greater responsibilities. - ;

, 4, IA recognition of her outstanding performance Lt 1a recommended that
y Misa Zehrung ba protiotal to grade 45-12,

PSone

s 4 ae

Weatern He Jephere Division

sor
Be

q
a


14-0000

_ S-B-CoR-E-T

Pape we

. ; Ay marco 1973

MEMORANDUM FOR: Charlotte Zehrung
VIA : Chief, WH/3/Mexico

othe

t

EE fats aye

1. You have been selected by your division, and authorized by the

' Clandestine Services Records Committee, to act as Records Officer for your com.
ponent. Your appointment ie based on your professional qualifications to carry

Be Neaag ae 7

out an assignment requiring experience, Judgment, and a knowledge of the

Clandestine Services objectives for your component.
2. You are to act on behalf of your Division or Staff element in authori«

Aemenmeieanan = SNORE,

zing the destruction of materfal of no value to the Clandestine Services in”

- accordance with criteria established for this purpose. You are empowered to

. i authorize. the destruction of documents and Index cards recommended for destruc-

tion by other members of your branch, and to desensitize KAPOK and RYBAT material

which 19 no longer sensitive or which has been restricted in error. Your signa-

ture will ba recagntzed by RI as that of an officlally appointed Records Officer.

3. A series of mestlugs vill be held in Rooa tur, £ Butlding te bries
3 "you and your colleagues on the detalla of your duties_as Records Officer. You

sve been acheduled to attend the meeting to be held on Wednesday, 2 April 1955,
1300 - 1645 hourn ; if it is nob posaible ror you to attend on the date
: designated, please call Extension 3325 to arrange for an alternate date.

Please veview the attached mterials prior to this meeting.
3 4 7
a IC Le
t. _ . UG 2. CUNNINGHAM
LDP Records Policy Officer
Attachueant

As stated

ee: Peraciunel Jacket of Addressee


14-0000

Tem soe

ad Claratly Aecontin,
ve \ SECRET. "Fa Contents

REQUEST FOR PERSONNEL ACTION

1. Seria Ne, 2. Home {Lont-b iret-Middlo)

Zen, & Charlotte L.

PREVIOUS aes

4. Oraonizsational Designetions 15, Location Of Official Station Station Code

DDP/WH
Branch III
Mexico Section Washington, D.C.
136. Oept.- Fiold [17. Position Title - 18, Position No. |19. Sore] 20. Occup. Serios
° xX [Cod
BA-0072.0L Ss 013? ahd
Zi. Grodek Stop [22. Salary Or Rave .[23. O 2a. Bore OF Grose 25, PS) Ove 26. Appropriution Number

biso Mo Ba wr ; .
ene lore pr] 3500-20

ACTION
27, Natura Of Action 28. EH. Date 29. Type Of Employes Code] 30. Separation Dara

ASSIGNMENT

oO ~ PRESENT ASSIGNMENT

ition OF Official tretien

sete ees cee eee ee

Liateen Cada}

TE bes

Sura Daayart hans
Lbe/wH

Franen IIT

Maxitéo Saction

i Gg

33 rear Field 44. 4, Position Title

Bape Code
ie 1.0. (FI)
Toda & Stop 39. Salary Or Rota 146,
trea
y $ 6605, L

e

SOURCE OF REGU

trey ena werenry veneer aerate ea manne rE phn ae
A, Roqvested Ay oon And Tiploh, 3 af UF av al tated ED
PLO, Onin ii/ I aradine CTiicer

apne ‘aii (Nana & & Talaphona Eery

Ramorks

se oe ae mn iy

rOoRM PPS2q

B-57 { 2 nominees eoeop


14-0000

, .
$ EG R EI be an

REQUEST FOR PeRsoWveL ACTION

1. Serio No. [2, Nome (Lavt-Firar-Middle) Fe an
CEHRUNG, Charlotte “ Py. in

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Organizational Designations : . 1S. Locotion Of Offtetol 5s

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4. “Fitness Reports" - May 1973 - Nov 1977

5S. “Fitness Reports" prior to 1957

6. “Other - admin material - after 1973

7. “Other"-admin material-prior to 1957

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AS APENDED, ANE AoDCI POLICY DEPECTIVE DATED 4 UCTORER 19420"

‘EFFECTIVE DATE OF PAY ADJUSTMENTS 10 OCTOBER 1965

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ACT OF 1964 PURSUANT TO THE AUTHORITY OF THE DIRECTOR
OF CENTRAL INTELLIGENCE AS PROVIDED IX THE CENTRAL
INTELLIGENCE AGENCY ACT OF 1949, AS AMENDED. AND POLICY
DIRECTIVE ISSUED BY THE ACTING DIRECTOR OF CENTRAL
INTELLIGENCE DATED 8 OCTOBER 1962.

2

SALARY CONVERTED TO RATE SHOWN FOR INDIVIDUAL'S GRADE
AND STEP AS INDICATED IN CHART BELOW. mo oo 7

GENERAL SCHEDULE RATES
Federal Employees Salary Act of 1964 _

-- mane 1 _ Per Annum Rates and Steps
-—_!ij 2/1 3 | #15 1] 6! 7) 8 | 9 {20

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Gs- 3 4,005} 4,140 4 293 z no 4, 545 4,680! 4,815! 4,950! 5,025} 5,220
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GsS- 5} 3,000] 5,165) .$,330) 5,495] 5,660} 5,825} 5,990: 6,155) 6.320 6,485
GS- 6| 5,505; 5,690! 5,875] 6,060] 6,245] 6,430) 6,615} 6,800) 6,925! 7,170
GS- 7) 6,050} 6,250) 6.450) 6,650) 6,850} 7,050) 7,250) 7,456) 7,650! 7,850
GS- 8! 6,630: 6,850) 7,070) 7,290) 7,510) 7,730 7950 8,170; 3,390! 8,610
GS- 9 7,220| 7,465; 7,710 7,955} 8,200} 8,445} 8,690; 8, 935) 9, 180! 9,425
GS-10] 7,900! 8,170! 8,440) 8,710] 8,980; 9,250} 9,520: 9,790)10,060:10, 330
GS-11} 8,650) 8 :945| 9, 240] 9,535! 9,830/10,125)10,420 19, 3 Rsvevrp S| 7305

10,605 ;10, ‘915 13" "315}11, 670|12,025|12,380: :12,735|13,690.13,445

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GS-15 '16.460/17,030:17, ‘600/18, 170|18,740|19,310119,880' 20 1450121,020; '21,590
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nan nt
ts PROJECTED SALARY YATE AND ering DATE

TO BE BE COMPLETED BY THE OFFICE OF COMPTROLLER
9. CHECK ONE PY no uxcessunse lan 610498 LaF 9. HUNGER OF KOURS LWOP

IF EXCESS LEAVE LWUP,- CHECK FOLLOWING:
1M PAY STATUS 47 G40 Of WAITING PERIOD

7
Cc i wwoe staréa AT S40 OF warsing wEaIOD

1G. Tuinacs OF CLEA OF CLEAK | it. AUDITED BY

nse) BE COMPLETES BY THE OFFICE OF PERSONNEL

[a. REMARKS

sALany +" -| pa

PERIODIC STEP INCREASE : ” AUTHENTICATION it
SEGRET

SLLUIMENT

&

i


14-0000

* [44 Remarks

SECRET (A 7

ay (Whon filled tn) 2
cs)
7. Date OF Birt [a Vor. Feo fr [5. sox [SSE
on Da. | Ye. oo ode “
12] 29 [ome }o TF 2
A CD
“A
€
“

29. Type Of Employes ‘Code| 30. Separation Data

REGULAR ‘01
PRESENT ASSIGNMENT

" [341. Organizational Designations 32. Location OF Official Station | Station Cage

DOP WH i

jORANCH 711 ly |

MEX LEO. Secrlicy : 613 WASH, , D. C a .

33. : ARS ssition Tidle 35~ Dostion No. 56. Sev.a7, Occup oli. .
ce +
‘fire 3 12 11.0. F 0521 es | 0136.51 .
” 133 Grado & Step 139° Salary € Naas 40, SD (a. fated 42, PS! Due * 143. Appropriation an Number !

| $ | Be Yr. | Mo. Da. Som
1, 041 0615818 20 ww

aaa 8? 1 150 +

rd

’ a a


14-0000

faa)

_ {27. Nature OF Action

REASSIGNMENT

BRANCH 111

MEXICO SECTION
et. - Field 734, Postion Ti de

5 fk. +
Uslid © ‘ oo
Fry REPORTS OFF

conn j _ 39. Salary G Or Rata
; 660 ol

“feaails

. Was gy 1850

SECRET
(When Filled In) . &

1, FEGU me

ie id No, 2. Nome (Lost-First-Middle) Bate OF Binh.
ts Da, | Ye. Rise eae
10 07661 ZERUNG CHARLOTTE, 12 27 pre 0 |F 2
. CS 1° cx 0. A dav.|1
. | Do. Sod oo od hal Yr. '.

PRESENT ASSIGNMENT

Cede fv Lucauen OF Olfichal Stauen

E13 WASH 0S

, Position Mo, 136 Serve

ae ——s 6] 43. Appropriation Mumbar

3500 20

15013

O1ge.4

“tation Garba

37, Occup. Sores
ue

(4)

uel

14-0000

oe

SECRE:

CLASSIFICATION

. - ay
me FITNESS REPORT
SECTION A GENERAL INE INFORMATION
1. EMPLOYEE NUMBER @. NAME (lost, fir, middie) “Ta, BATE OF BIRTH ean fa. ORADE
F |Gs-l

007667 . | Bustos-Videla, Charlotte Z, [2 Jan 29

0. OFF DiV/OR OF ASSIGNMENT e. CURRENT STATION

DDO/WH/1

7, OFFICIAL POSITION TITLE:

Operations Officer

1a. TYPS OF REPORT

at, Tyra © or SF APPOINTMENT

eal fem] bet ] icon
PoRAR

' 14, DATE REPORT OUR IN OR
3 .

SPORTING PERIOD (from
ATAIRX 1 August. "to72 .30 April 19 ;
‘ “QUALIFICATIONS UPDATE

1$ BEING SUBMITTED WITH CHANGES, AND 1S ATTACHED TO THIS nerort, PLACE TNE
if NO CHANGES ARE REQUIRED, PLACE THE WORD “NO” IN THE 80x AT RIGHT.

ECTION CO PERFORMANCE _EVALUATION_

U—Unsarilostory Peclormance is vnocceptobls, A rating In this cotegery requires bamediate eed positive remedial action the rowe of the action
could range from sauna to further training, to placing on proboticn, to recuigament of fo seporotion, Describe action token
or proposed in Section D.

M—Morginst = _ Perlormonce ts deficient in tome aspects, The teatons for amigning thh retin showld be stated in Section O and remedial oxtlons

taken of recommended should be deveribed:-
Performance is satisfactory. Desired results ore being reduced ia he EebARee Bi pected.

P—Proficient
$— Strong” Performance in charettorlaed by excaptional profictency,
Pe‘tormance Is s0 exceptional in ralation to requiremeans of the wok ond In comporiton to the porformonce of others doing simitor

O—Oviitonding
work Gb to worradt spotlal recognition.
SPECIFIC I DUTIES

Uist up to ala of the most Important epecific dutles performed ducing the rating ported. Inasst rating fetta, which bert describes the mannet In whlch employee
forme EACH specitic duty. Consider ONLY olfectivenens in performance of thot duty. All emphyywes with wpervisery cosponsibilitios MUST be roted on

thelr ability fo svpervise (indicate number of employees supervised).

If QUALIFICATIONS UPDATE FORM
WORD “YES” IN THE BOX TO THE RIGHT.

SPECIFIC DUTY NO. t
LETTER

‘Functions as Chief of the WH/!/SA and Cuba Section, supervising, :
one case officer, one IA and one Secretary. ; Vee ey 8

~ "Farina
| beTIeR

aPRCI RS burr NO. a. 8
Analyzes all tr affie pertaining tu Draneh "and Static: SA and Cuban

i
Operations, performs ull operational support, project actions, corres-
pondence, coordination, memoranda’ and file maintenance, | pa 0. .
: RATING
LarTar

ePdciric Qury ‘No. 3 d
Prep ares studies, file analyses and special reports such as budget
oO

and program call and correspondence with the Waite House,

ee netnnene mene ey Pee oe ere

BPACIFIC DUTY NO. 4

nc one on ree raw een ea arnt en ae ee A RN at ee nn
RATING

SPECIFIC DUTY NO. B | Lmrtar
4

SrEciFic our NO. a ,
RSTTEA

ent tee oe win SOWERALL PERFORMANCE IN CURRENT POSITION
a Fe [RATING

Toke late cecowat overthing abou! the orployea which Influences hit eHevtrenaeis ia his evreent poetics wich aa patormance of specific deta (LATTER

productivity, conduct 24 job, cooperstivenau, pertivest personal traits ce wobin, aad putticuias Latatexa ce ‘ofeetn Based on your lrowtedgze

of employee's overall performance during the rating pariod, glace the fater ia the tutag Dax correrpancag 09 Fhe statement whud moat ett i S

cately ratlacts his bevel of performence.

Por 5 CLASSIFICATION ” ne ”
Forns 45 OSSOLETE FRevICUE 05 5272 may)

ir?) EDITIONS . etc -3t9eta
a SECRE} 22 BAPOdT Ct 8 oe ie


14-0000

Creme

CLASSIFICATION
SECTION O NARRATIVE COMMENTS

Indicate significant strengths or woaknones demonstrated in cyerent position keeping in proper perspective their tvlationship to overall petorwmane State
tuggertions made for improvement of work perormance. Cive recommendations for Waining Comment on toreign longvage competonce. H required for.
tvrrent position. Amplity or explain ratings given in Section C bi sprovide bop bert for Serger ining future pervonnel action Manner of pecfarmance of of

monageriol or wpervitory duties and cos! consciquecess ia the wie of pattonnal, space, ogvipmeat_ond funds mvit_be tommerted on, 4 opplicatle. cy

extra.spoce ly needed to complate. Section 0, attach a seperate theet of paper.

. In the 8 months during. which she was under my supervision, Mrs. Bustos has
performed in. that. same hard-working, highly-productive style which has become
her trademark over the years, She understands the intelligence process from
start to finish and {s personally experienced with each step along the way, save the
agent handling aspects. She excels in each phase of the work.

As chief of the Branch SA and Cuban activities section; she has once again
demonstrated her mastery over her assigned duties. Stie is a sound, dependable,
yet imaginative and energetic operations officer, whose performance leaves Little
tobe desired, While she had had little previous supervisory experience, she has
in this assignment demonstrated exemplary supervisory ability. Notwithstanding
her drive, tenacity and attention to detail, she is a popular co-worker, is receptive
to guidance and is sensitive to, and responsive to the needs of her subordinates,

‘Inher performance of specific duty No. 2, she has brought to bear upon her
daily duties her broad experience, high fiitellfgence- and good. operational sense,
functioning with practically no need of close supervision. It is comforting to ~
know that gn assignment given to this employee is always done promptly, pro-
fessionally and cheerfully,

Her adaptability was demonstrated in her specific duty No. 3, Despite the
press of normal daily activity, she was often called upon to produce "crash"

continued
SECTION E : CERTIFICATION AND COMMENTS
geo EMPLOYER
oe. P CERMEY THAT | HAVE SEEN SFCTIONS A. 8, C ANO D OF THIS REPORT
SATE a Mab dete ae ,

wt wt Dey eae oe Lit few: Bee. mA ve eet bee
a av SUPERVISOR

MONTH # FMPLOYER WAS oeen

Ta THIg REPORT H HAS NOT DEEN CHOWN TO EMPLOYER. ave (SNPLANATION
UNDER MY BUPENVIBSION .

8 |
ote SCS ‘DerigiaL THLE OF GUPESAVISOR Te EO one BANTEO NAME pags 1EASTUPE,
. | AP ap sence KA A
21 May 1973 | DC/WH/L_ Raymond 3.8} wider _
3 BY REVIEWING OFFICIAL

COMMENTS OF REVIEWING OFFICIAL “The rater has written an accurate and thorough evaluation

of Mrs. Bustos, I concur without reservation in the ratings provided subject.
She is an exceptional officer. Her ability to perform a varicty of ase guments
in Headquarters and the Field has measured up to an outstanding record, Her
work with subordinates clearly indicate she is a good supervisor, Mrs, Bustos —
performs all facets of her work in an exemplary manner and in my judgement
rates in the upper percentile in the A Category.

Qe

OATR eI AL TITER OF RIWIEWING OFICIAL. “TS TYKED Span wAMS Ont BIGHAEURE
t

. i « we;
2 May 1973 : C/WH/L th Ghn C. Murray
. . . “SIC ATO 7
SECR CT

i
:

voy . : are

-2-

Narrative Comments (continued): (Charlotte Z. Bustos-Videla)

papers for the Branch because of her innate talents and
established reliability. She never failed to impress her super-
visor with her production, writing ability and energy. Her. overall
performance is clearly in excess of her grade level

In terms of true cost and Security-consciousness, she must also
be considered very strong because she has a positive and aggressive
attitude towards these subjects, It is with deep regret that the
Branch parts with this employee who now moves up to the Division
front office staff,

z

14-0000

“— , po,
CHO-N-F-1-DeE-NoToReAcL

nes

Covert Action Operations Seminar io, 2-73

35 hours, full time

Participant ; Bustos-Videla, Charlotte Office ; WH
Year of Birth: 1929 . Service besignations D
Grade 3 GS-13 Ho. of Students 3 20

€0D Date : 08/51

COURSE OBJECTIVES, CONTENT AND METHODS -

The objective of the Seminar is to give the participant a familiarization
with the major fields of covert action, These are viewed as;

— | Polteteal Operations, -Including Propaganda;

wo Operations Against Priority Targets end
Oenled Areas. . :

("Priority targets” is taken to include
Sovlet Bloc, Chinese Communist, Cuban,
and North Vietnazese officials and
other personnel in third countries,

and other designated targets)

The Seatnar includes a discussion cof the “political aniral!! and
BA analytical lowk at the political gersunality.

Tho technique of Instruction is one of talks Ly Sperations Officers
experienced im varlous specif le kines df G5eTation, folloued by questions 7
and ciscussion. Participants are encouraged and exsected to ask questions
and engage In the discussions, drawing uson and reigring their exparience
to that under discussion, Ona ef the jzcortent vaices to be gained from
the d.miinar is this exchange of experierce,

ACKTEVEMENT RECORD

a 7 rf . . : . . i .
Yois is a certificate of attendence. No further assessment of individual
Capacity or performanca is made in this course. 2

FOR THe BURECTCR CF TRAINING: —?

‘tied Cl * Lee ht. fob 133
F z

Hocherd A, Fulier da
Chief Instructor

CoOeNe Fo) -O-c-N-T- PAL

petals iets ee “rite

14-0000

enna nn yes
mr rented sttite ns 2 24

+ re et nti eee

fy . ey

CONFIDENTIAL

TRAINING REPORT . . .

Midcare'er Course No, 34

Student : Bustos-Videla, Charlotte. Date £11/5-12/22/72

Year of Birth: 1929 Office >WH/I

Grade : 13 Service Designation: D

2

No. of Students : 30

fee 8

COURSE OBJECTIVES -- CONTENT. AND METHODS

Tha Midcareer Course is ) dvoigied to enable potential executive | -
officers to develop and widen their understanding of management “

practices, of the Agency and the [Intelligence Community, and of the

Government's involvement in international affaire,

The Course consists of three major segments of varying lengths.
The topics covered through lectures, seminars, group discussions
and field trips are:

I. Effective managerial behavior ag derived through study

ot tune Mauagertal Grid.

2. The functions, relationships and problems of various
Agency components and of members of-the Intelligence _

Community.

3. Selected elements of national power and current develop-
ments in key international affaira.-

ACHIEVEMENT RECORD

No evaluation of the student is made during the Course, and no
final grade ia given upon course completion,

FOR THE DIRECTOR OF TRAINING:

(y idcarcer Course Chairman

Clavagified by: 17-1626
EX-2, APDCI, CONFIDENTIAL

WSISNi

14-0000

“Ny SECRET

(Oren Pitted Ind

SMPLOTEE TETIAL NUMBER

007667
pees (Mid te) fa. OF TE UP GIRTH

——““teat)SS 4. GRADE |" x0
Bustos-Videla, Charlotte Zz. /12 Jan 29 | GS-13 |
a a nt

Mexico City .

GENERAL

6. OFFICIAL POSTION TITLE

Operations Officer DDP/WH/1

16. CHUCK (RIT YOR OF AaPoRT

; epacias (Specty)
18, BRPORTING PERIOD (From to)

1 January - 31 July

PERFORMANCE EVALUATION

Ctreastshastory Performance is wnaceeptable. A rotag this cotegory sequstes ommedsate ond postive temadial action. The aoture of tha oction
~ could renga from counseling, to further troiaing, bo plassag cn probation, to seanigamant of fo soperatpa. Describe octon token

. of proposed in Section C

Performance is deficient in some ewpects. Tha reasons for ategaing this rating thould be stoted in Section C cad remedial! ochoms

Bh -then gene
- - takes of recommended should be described.
PD Micinnd Performance is satisfactory. Derired-ressdts-are bemg produced: wn the manner expected, - - = ~ -
S Heng Performance 1s charocissacd by exceptional proficiessy.
wow Parlormance is 0 eccephional in relation to requirements of the work and in comporizon to the performones of others doing similar

SSNS
work 02 to worcant special recognition.’

{nee vp te sis of the moot Important spacilic duties porlormod during the rating period. Insert rating letter which best describos the
mr wa which employes performs EACH specific duly. Consider ONLY effectiveness in performance of thet duty. All employces
siete supe visory responsibilities MUST be rated on their ability to mapavise (indicate number of employees suparvieed),

WResese OuTy HO. t

Prepares operational target studies on PRRUMEN officials and
assists in the planning of operations against these targets. ‘

Rating
Lerten

S

Toes trwe gute Na

Screen: all agent aud technical reports dealing vith PUNCMEN
tarsets for operational and positive information and puts in

retrisvahte- ~ forme - -- - een

“gieieta Caso Officers in preparation of operational reports
sd eeing all basic research such as tracing and file reviews and

RATING
Lat raa

presents the results in exploitable form. o
EE corres

wae rig guir Ho. 4

Prepares draft intelligence reports from raw agent reports,

secbnical operations and defector debriefings. 0

RATING
eerTzia

Jie twee pure ya. 8

GOA/DTEO Project Officer

TNgGeAPIS Gary wo.’

Kanapyement of the PBRUMEN section files. 12°55
. es

OVERALL PERE PGRMARCE IN CURRENT POSTION _

a@re <TD atianent owetything ubow the amployse which influancas kis ofinctivensus in hit ewiont position such a pare
lormense at apacifle duties, wroductivity, candice om jum, ceapercteanosa, pertirent poreonal prurda ee Radits, aed
eer eane lieectotions er tule Based sa you trceledge of peplarse’s warnll perinsmunce during the rotiag parted,
euece tee letter to the rating bea currasponding to the sofement ahegh post occiuzutely eafiests bis lave! of perlet-ance.

po eee OO

Natya tes were re eral te ge

SECRET Demses i Se OMS Diy reg

exer a5 SECRETE MEP. EO.rerNS


14-0000

SECRET

+ COkon Fretted In)
SECTION C NARRATIVE COMMENTS
Indicate eighificont strengths or weckneeses demonstrated in current position keeping in proper perspective their celetion ch:2

overall performance, Siote suggestions moce for improvement of worh performance. Give recommendetions for training, Corer ere

on foreign longuage competence, if required bor cuttent position. Amplify or expicin rotings given in Section B to.provide best
ot tupervisary duties ond coat conseiog urest

bose for determining futur * rtosnonce of m: erie
athe iff 3 s H I spacer eauiament ond inedeteuit by sosmanied ron an strate “Weatra spoce is needed 0 complete
octron G ottoch @ sepurste sheet of pope. TH reviewing my previous fitness report and
those of my predecessors, on this fine officer, I find myself hard put
not to repeat what has been said so often before. She has been the back-
bone of ‘this section and of those where she has worked previously. Her
work has always shown excellent judgement and ingenuity. A self-starter
with tremendous drive and discipline, the amount of work she has produced
has been prodigious. ..An_ excellent team worker, she has never shirked wheh-
: as so often happens = she is asked to take on additional work or work cn
a matter outside of her regular field. While forceful, she is diplomati .
and tactful and is able to present suggestions and criticisms in a plea-
sant manner. She is one of the most dedicated persons I have met in the
Organization, and exceptionally dependable. While, as a: woman and a
Specialist, she has had little opportunity to handle agents she has done
very well with those we have given her to handle. She has showed great
: ability in the training of two transcribers and in the debriefing of tv¥o_
: female agents and their husbands, This is in large part due to her in-~ oo. oe
- --ldepth -knowledge of the targets this section 18 Working on. Tté past few f-
months have, been difficult, requiring the complete reorganization of this
‘Section and the termination of the majority of our assets. - Under this
i stress, she has performed in her usual outstanding amanner. Perhaps,
even a little better. Her handling of a great deal of file work has been
- Jexcellent, probably in part because she was the one who set it up and has

2 maintained it in its present very good state. (continued)
SECTION D CERTIFICATION AND COMMENTS:

SY EMPLOYEE
UCERTIFY THAT f HAVE SEEN SECTIONS A, 8, ANO C OF THIS REPORT.
SIGNATURE OF EMPLOYEE

7 Avy 1972 {

OATE
/s/ Charlotte 4%, Bustos-Vadela

2 Gf SUPER OGR .
MONTHA EMPLOYEE 046 BEEN Viv vais AN PORT HAS WT RE EN SHOWN TO EMPLOYEE, GIVE EXPLANATION
UNOER MY SUPERVISION

YPEOQ GR PRISTED NAME AMO SIGNATUPE

DATE DPFICIAL TIVUR OF SUPERVISOR iv
t
7 Autsust 1972 Operations Officer /s/ John M, Burke

1. __ _ _ BY REVIEWING OFFICIAL
COMMENTS OF RE VibwiNnG OF Fici4aL
Withont any hesitation I concur with the outstanding ratings
. nhove. Subject is now up for rotation and we will miss her
immensely. For yenrs she has dedicated her entire time to her job
which she has done so well. She has been creative, thorough and
accurate. Although she has not had supervisory experience at this
stution, sho has performed in a.manner which clearly reflects that
sho would have no preblem with supervising. A truly outstanding

employeo with growth potential.

ar ER TE TAL T TLE UF BE WIROING OF PIGIAL NV PYFED OF FS UTED WAME ENG SQMA TURE
i \ fs/ George A Tt
7 Aug 1972 . pcos : BETO XR

SECRET
“ed


1400000

a > SECRET “

(CONTINUED) '
: SECTION C NARRATIVE COMMENTS
j .
i The one criticism of this Officer's work that I and others ;
j have made in the past still stands. She tries to do everything '
and somethings in this business just don't deserve the attention | i
she gives them. . , Oo .
i
I have no personal knowledge of her supervisor abilities, . .
but believe she is a natural leader. ;
: |

gre ara
or |


14-0000

-
” SECRET

rOren Potted fa)

WMPLOVYER SARIAL NUMBER

007667

FITNESS REPORT

GENERAL
th wame (hae) (Fteet) enna) iz OA TEP QI Ee. 4 ry
Bustos-Videla, Charlotte Z, {12 Jan 29°| F['ascisl Dp

1, CPF/DIV/OR OF ASSIGNMENT 16. CURRENT STATION
DDP/WH/1 Mexico Ci ty

8. Cem Cn (A) TYPE OF APPOINTMENT 10. ChacM in) TYPE OF REPORT

| PE eiketnerionas os mincing zecne a ID
BPacian (Specity): «

spactas (Specity):
1}, QATE REPORT QUE I OP,

6. OP FICIAL PORTION TITLE

Operations Officer

12. REPORTING PERIOD (Prom te)

January 1971 - December 1971

SECTION 8 ERFORMANCE EVALUATION

U-Uneatistactory Perlormonce it unacceptable. A rating in thin category eaquires immediots ond positive remedral action, Tha nature of the ection
~— could range from counseling, to further troincag, te placing oa probaticn, to reasugnment of ta separation. Describe oction totea
ot proposed in Section C.

PeHfarnande ua defizidnt in some Sipacta: TEE veusang Tor oisigaiig this iotiag thould ba slated in Section ¢ and ‘remedial Gitient”

~ “UO M=Margitel
oe tetca ar teeommended should be derenbed,
P-ProReient Peformance is sotisfoctory. Derired: retutts ave doing produced in the manner expected.
“] S-Strong Purformanes is chasocteritad by exceptional nreFerency. : “yO

O-Outatsading Barflormonce is-to exceptional in relation ts reqeimemests of the work and in comporison to the Performance of others doing similor.
woik as 10 warstent spacial ‘secagnition, | . .

__ PECIFE DUTIE $s : -
List up te six of tho meet important specific dutios performed diving ‘the roting porlod. insost rating loner which best describes the

monner inv which employes porforms EACH apecifre duty. Considar ONLY affoctiveness in performance of that duty. All employees
with supervisory rosponsibiliiios MUST be rated on their adility to suporvize (indicate number of amplayeco supervised).

q ao.8 ”
oPaciwic CUTT NO cerrea

Prepares operational target studics on PBRUMEN officials and
assist» in the planning of operations azainst these targets.

Tercewre cule Me ee — ~— ~ ™ rarres
Sereens all raw reports dealing with PBRUMEN_targets for _ -_. 7
Operational and positive intelligence. s

SPadciric OTT ND “— _ aria
Conducts namc checks, filo reviews, prepares finished memos,
eables, and dispatches. Assists Case Officers in preparation oO

sational reports.
To amar nmetewnanenat cone ne nee ~ RATING
RETICR
Prepares draft intelligence reports from raw agent reports,
technical operations and defector debricfings. (0)
sPRC eS ” ‘ atres

Handles miscollaneous special projects for the Station; screening
and vcoufing to all Seetions daily audio tnke;: operational report-/ s

ject responsibility for COA/DETO project. _

pe ann OVERALL PE RFORMANCE

Tabs imho ace peed over pthiag adeut the caployes which tpSuseces bla eHectreneds in his exter? poaltios such 06 pare
formance of ppecti ddtea, protuctieiy, cordver un pe, coepavativeasan, gertinant mavacnal traits er hebst0, ored

wetigwios Hortaness e totem Based on you besulesss st emaloyaa's oware!! paslormance dutiny the rating paried,
pteve the bere: 2 tho rating dee cospapending tp 1p sretement ehech moet acqwataly esileste hye loval of paviennonce.

RAT OES
Lerran

Tee eantat amma anibunstraniaetedenaneeemmueeeminaeetnanteneeeeaeS

SECRET ieee end bs GPyAPD

IPPR

ace 3 CRORE eee e Be hens
+o


14-09000

wan ee

SECTION C

-FMONTHE WePCOVEE WAS HEEN
WADER MY IVPEA VISION

CRET

CUres Fitted Ta)
NARRATIVE COMMENTS

Indicote significant strengtha or wecknestes demonstrated in curtent position keeping in proper perspective their relationship te
overall performance. State suggestions made for Improvement of work performance, Give recommendations tor treining, Comment
an loralgn fangvage competence, if required for current posetion, Amplify of explain ratings given in Section B te provide best
bLusis for derermining lutvre personnel action. Managt of performonce of monogariol of supervisory dutias und cost consciou mene
in the vae of perscnnel, space, eavioment oad funds, _evat he coany eplis » Wentra spece is needed to complete

Section C, ottach @ sepurcte sheot of paper 8 55 nt
This supervisor naw Usb eked with a varioty of Intelligence

Many were good, but none compared with this Subject.

astest working IA I have met. Her

: Hor knowlédge

Assistants.
She is the most thorough and, &
capacity for hard work and long hours is prodigious.

of operational matters is equal to that of most case officers. She
has an operationally crentive mind and has-made many excellent.
Additionally,

suggestions for the improvement of the section's work.
her command of the Spanish language onhances all of the above abilitie
This officer has found hor very pleasant to work with. She has a
unigue ability to make constructive criticism in a tactful manner.

If this Subject has a weakness, it was pointed out by the reviewing
officer in the last fitness report when he said, “in her voracious
appetite for all kinds of facts (she) can at timos put undue emphasis
on them, including factual minutiae as against cqually important but
more elusive subjective factors. : . :

Because of hor outstanding performanco and abilities the Subject
wilI be given some activity handling agent_porsonnel, during the

forthcoming year.
The Subject's continued fine performance sinco her last promotion

merits special consideration by the Promotion Board.

SECTION DT CERTIFICATION AND COMMENTS
_ . BY EMPLO YEE

‘.
_ 1 EFRTIF? THAT 1 HAVE SEPN SFCTICNS A, 8, AND C OF THIS REPORF
DP RPT OP PUP U TE I re me 8
9 December 1974 /s/ Charlotte Z. Rustos-Videla .

BY SUPERVISOR . _

2.
iP THI3 REPORT MASNOT BEEN SHOWN TO UMPLOTEK, GIVE-HAPLANATION

TTYPZO OW PRINTED NAMG AND SONATUREG

{
Ops Officer. /s/ John M, Burke

9 December 1971
3.

COMMENTS UF REVIEGING OFFICIAL
Y concur. with the above ratings and comments.

the tasks outlined above in a very professional and methodical manner.
One does not even sense that the work is going on until tho tinished
product is produced. It is aiways excellent. We count heavily on her
thoughts and ideas in all operational studies and considerations. She
is ops oriented and has an excellent bank of information to eall on
-when necessary. She is pleasant and has the respect of her co-workors
as well as her supervisors. Her abilitics are varied and she can be
counted on to perform oxtremely well regardless of assignment or target
We will be losing this fine officer soon and we will be hard put to

ind someone who will bo able to replace her.
WITCE OF REVitwia Ge riciAg [TYPED OF PA INTE NAMA AND SIGNATUSE

— POR PR ICIAL ,
/sa/ George A. Fill

GATE WUT TDF PICIAL TITLE OF SUPERVISOR

Subject performs alt

RY REVIEWING OFFICIAL

oats
9 December 1971 Deputy Chief of Station;
SECRET

14-0000

fee ke . . SECRET

(Wares Frtfed In)

FITNESS REPORT

Tame @ z (Micdte) 4. CATE OF BIATH .
bustos-Vitta, cranllms 2,0" [2 dan,29 |p (08-13 |
8. OPriciay POSITION TIThLE . % ORFs OF ASSIGNMENT (8. CURRENT STATION
Qpertione Uiftcer bier ee'a
Pe cueenin) tyre gr apparent eee vee oe Ree
OC CI
|] [ camaun-rnovisiona (See inateucitone > Section C) i XXlewue Tne assionmanT amecoves |
[—orecras pest | sera net
Ut. GATE REPORT OVE IN 0.8, 14. REPORTING PERIOD (Fram toy)
. : 1 January - 31 December 1970

PERFORMANCE EVALUATION

Parformonce is unoaceptable. A rating in this cotegory, requires immediate ond positive remedial action. The natwe of the action
could ronge from counscling, to further training, to ploeing on probction, to reatugamant of to reparation. Daseribe action taten

of proposed in Seetion C, 1

Performance is deficient in rome oepacts. The cecions for assigning this rating should be stated in Section C ond remedial actions
token of recommended should be described.

Parformonasis solisfactory, Desised rasulty ore being produced is the manner expected,

Parformonce it cherocterited by exceptional pioficiescy.

Pasformance is +0 axceptional in relation to requirements of the work and in compotion to the performances of others doing similar
work os to worrant spacial recognition, .

SPECIFIC DUTIES

Lise up ta sin of the moat important apacilic duties perlormod during tho raring period. Insert rating lotter which best dosccibes the
manner in which employoe performs LACH specific duty. Consider ONLY ofectiveness in performance of that duty. Al! amployees

with supervisory responsibilities MUST be reted on their ability to supervise (indicate number Gf employoos eupervised).

TPECIIE DUTT HO. Prepares opera ational target studies on PBRUMEN eres
officials of interest and helps “in tho preparation of operational
Planning re target porsonnel. tyres Qo.
Sveci#e uuryvay eT eee wa ee
Serecas the raw reports Srom technical operations and agents Cor
Operationally uselut information, fo)
seuciPtE BET RoS Provides” ‘Operational. and adminis trative Sipport for RATING,
station PBRUMEN activities. ‘This includes name chocks, file °

reviews, preparation of memos, cables and dispatches, and helps in
ho preparation of project reports, outlines, and renewals...

seecimicourr ses Sipervises bho handling of the station PBRUMEN watch- [ce
list and in general monitors travel of interest to and from PBRUME.

for our station, Headquarters and other stations.

seu CIEIC OUT Y NO. 3 Helps the station intelligence chief in tho proparationcerrés |
of finished intelligence reports from a PBRUMEN refugeo debricfing

center (only part of the reporting periad).

weeciric purr mo. @ Handles Mm: misceltancous special projects for the station) AYiy
du uddition to her PBRUMEN duties (exanples: organization of

station watchlists during a presidential visit, screening cortain

paw reports tor wholo station, preparation of _OQA/D'1O projec nan

OVERALL PERFORMANCE IN CURRENT POSITION xe
Te ot ae [oa no

LEIVIER

Take Into accourt seatything about the employoo which Influences hia sfloctiverass in his currant postioa. puch a6 pare
formance of agerihc dutios, productivity, conduct on job, coooeronvaness, pertinant parsanal trains o Rebers, ond |
poctlcular limitations ef ralanta, Buses on your knawledgea cf seployce's overol! petlormance duting the Aten perind,| fe)

place the lattes in Ihe rating bom cormespanding to the statement ahich moet uccwately rollects hit level af petlornunce,

mena

SECRET

eon a RY: rote ye
Dae $$ ceacuass essa. e soins vee, Plv ees

14-0000

SECRET

CBben Filled dad
SECTION C NARRATIVE COMMENTS
indicote significant Strenpihe oF weaknesses demonstrated in current position hoeping in proper Perspective thelr relationship to

overall performances, Store suggestions made for improvement ol cath, periormonce. Give tecormendutions foe training. Comm oni

on Inewiyn donguoye competence, if tequirnd for durrint position, Amolily or explain ratings given in Section B to provide heat
duties ond cost cantclovingas

basis lor determining futute passonnet action. Monner of perfgenance of managerial Pitveenisen. ” at
in the ute of personnel, space, eavirment ond fynds, must te commented on i opplicable. WFeutra space 1s needed to complate
Section C, ottoch o separate thearo poper, °

J .

Subject worked most of ffb}2ycGoanl the station PBRUMEN section. She
was clearly outstanding in collating information from all sources
during a recent intensified “PBRUMEN" month, dotermining as a result
the overall pattern of tho PBRUMEN mission here, spotting operational
leads and updating target studies on all PBRUMEN officials as a result.
Her final writeup regarding both new information obtained and the gaps
that romain was thorough and useful.

Subject 1s oxtraordinarily rapid and efficient in researching for
info, organizing files and other material and writing up any kind of
resulting memo or dispatch. The same might be said perhaps of some
Other real pros in the IA field. Howevor, in addition, Subject has a
Good, tough, operations-oriented mind and positively contributes ideas:

| and suggestions re new operational techniques which the station -has
uscd profitably. Subject has natural managerial abilities as recontly
demonstrated in her organizing TDY help in a station-wide fito and
watchlist effort in connection with a presidential visit. Her Spanish
is more than udequate for reading reports, and handling operational
messages in that language. In sum, Subject is a tremendous station
asset and would be extremely hard to replace without noting a serious
loss in station officitency. . .

zs -continued

CERTIFICATION AND COMMENTS
BY EMPLOYEE 7 :
CER TIP? THAT PAVE SURE SE CTITS A, 5, AND C OF FRIt REASST

SECTIOND
in .

PSIGNATURS OF TMT CO e
3 arch 1972 Lil crarlotes 2.
2 BY SUPEA VISOR __

tacit PHS EMPLOTER AS BEEN i THIS HP PGRT HAS NOT DEEN SHOWN TO-EM*LOYEE, GIVE EXPLANATION .

UNOBR MY SUPER VISION

TYPES O8 PRINTEO NAME AND SIGNATURE

wATZ. - FOP FIGIAL TITLE OF SUPLAVIZOR
) March Lorysl Operations Officer sf John Isesinger
22! P acer eh OL MON SESE OSCE
3.- BY REVIEWING OF FICIAL .

COMMENTS OF AUVIGING GFPICIAL

_ Although in my opinion there is an excessive use of “‘outstanding"
by the rating officer, f’am in accord with his narrative comments.
Subject is definitely more than an IA and has performed as such when
the station has required an individual with in-depth knowledge of
station procedures, operational awareness combined with an ability to
propare studies in a short poriod of timo. She's thorough, concise
and vapid. One of our hardest workers and most dependable employees.

TOR PICIAL VIVE OP REVIESING OFFICIAL [FFPED OR CRIN~ SC VAME AND SHUMATURL

, } Deputy Chief of Station i /sf George A. PILL

[Outs

25 March O71

SECRET

14-0000

SECTION C NARRATIVE COMMENTS continued

Three rather personalized comments might add meaning a ‘
to this fitness report. Anyone, particularly a fomale, :
fitting the above description of efficiency and achievement _ .
can be, and often is a little overbearing and difficult to
work with as a person. Subject, withall, is a pleasant
porsonality who knows how to make her contributions and
comments in a forthright but tactful manner. Secondly, and :
this one is a littlo hard to say, Subject in her voracious . ao
appetite for all kinds of facts can at times put undue
emphasis on them including factual minutiae as against
equally important but more clusive subjective factors.

Thirdly, this rating officer has personally observed Subject -

only working on station premises at an office job, and

frankly has no idea how she might function in outside | ; ; -
operational work (cultivating poople, working under outside ~~~" : .
cover). .

Tee = ne eee a a ns mena ENN RR! Erol Lee oo wm en oe ih

ee

wowed ity GY 500; 2PB


14-0000

MEMORANDUM FOR THE RECORD - Cy are v7 ne (Btesres Voce \

SUBJECT: Ovcrall Outstanding Rating on aD:
Mothod of Recognition

1. This memo is boing written in accordance with
paragraph three of Book Dispatch 5273 of 12 April 1966.

2 TRS MAwas last granted a Quality. Step Increase
about a year ago in recognition of her very fine performance. |;
It is a little early. to repeat that kind of recognition even :
though it is u most logical and meaningful means to show :
recognition of hor outstanding work. . 4

en RE Ame RL esate ebee ae ome cata *

' 3. Consideration should be given lo an appropriate
_ occasion in tho . fairly near future to grant another

“- -QSI. to @ ae 7 : .

Basen og ay SPD PDB


14-0000

, uo . ’ SECRET 7 4

(When Pitted In)

SUPLOVEER SERIAL NUMBER

007667

2. OATE OF BIRTH |B. SEX 4. GRADE

7. OF P/DIV/BR OF ASSIGNMENT /8. CURRENT STATION

Mexico City

(Michie)

9. CHECK (X) TYPE OF APPOIRT MENT 10. CMECK (XD TYPE OF REPORT

Ganeanconaviaiowsy (Bee heirs ilong«BestlonC) xx Tamawac ra asnrowman i aurcovee |

= :
[Jorucran Greets SSCs tk Set
11. DATE REPORY DUE IN OP. 12. PEPORTING PERICD (Frum: to)
28 February 1970 1 August 1939 ~ 31 Detenber 1969
. PERFORMANCE EVALUATION . x

Performance rongos from wholly Inadequate to slightly loss than eotialactory. A rating In this category requires
positive reaedigl action. The nature of the action could range from counsoling, te furthor training, to plocing on
probation, to reassignment of to sepuration, Describe action token of proposed In Section C.

Porlormonce moots all requiromente. It is entirely satisfocrory ond ie characterized neither by deflctoncy nor

excellence.

P + Proficient Porformanes is more than aati stactoiy. Desired results are baing produced In a proficlent manner.

5 + Strong + Performance is chorecterlied by exceptional proficiency.
O- Oyistanding Performence i¢ 99 exceptional Infolation to requirements of the work and in comporison to the performonce of
othera doing similar work as to warrant special recognition.

PECIFIC OUTIE
List up to six of tho most impertant spocitle dutlas porformod during the rating period. Insert rating letter which bast dascribos the

manner in which employee performs EACH spacific duty. Considar ONLY eHectiveness in perloemonce of that duty. All employees] .
with supervisory renponsibilitias AUST be rated on thelr abillty to supervise findicate number of employnas supervined). f

SPFeIPIC DUTY NO. Ft
Eonpt leto reorganization of Station files, including

development of anew proceduros, revision of file categories,.
consol tdation, purging and’ destruction, ° pe

Durer, @

“Provides overall gaidance to Blation add fDY personnel
engaged in reorganizatlon of Station files. Supervision of

Secrotary-Receptiontst.. - oo - ; : - oo Ss
SPECIFIC DUTY NO-d aes a : — - “RATING
Spocial assistance to COS/DCO3 in revanping the paper flow LETTER
withla the Station and betwoon the Station and other Government
s_

avencics.

sreciric DUTY MO, 4

veparation of spectal studies for the COS/D503 concerning Lhe
effectivaness of Station papor handling procedires,. personnel
econonies related thereto and the improvement of Station
wecivic buryna,s ULLIZaALion Ol mnHpowor, space and funds as a result RATING
of the reorganization of Station Registry functions . verren
. s

and personnel, an erReeaees .

FAT Nfag
LLErren

SPECIFIC BUTT NO. 6

be
OVERALL PERFORMANCE IN CURRENT POSITION

RATING

LETTER

Take into account everything chau rho eaployoa which Influences his offectivensss in his current position such a2 per
formunce of «pacific duties, productivity, conduct on job, cosperctieeness, paettinent personal traits of habits, and
porscolar limitations of talenrs. Ez2ed en your knowledge cf ompiayos’s overall performance during the rating porod, S
ploce the letter in the rating bas correspondiry to tha statement which ost occurataly caflocts his lavel of performance.

F084 45 uss eagvious agitioas SECRET

en

14-0000

SECRET

(When Filled Ind
SECTION C _ NARRATIVE COMMENTS

Indicate significant strengths or weohnosses demonstrated In current position keeping in proper perspective their relationship to
overall performance, Stara suggestions mode for improvement of work performance. Give recommendotion s for training, Comment
on foreign language competence, if requited for current position. Amplify of explain ratings given in Section 8 te provide best
bosis for determining future personnel action. Monnec_e! potformonce of manogerial or [ot _tupscel sore duties ond cost corsclousness
Teable. H extra space is needed to complete

in the use of personnel, spoce, equipment gnd fynds, must be commented on, if o

“| Section C, attach a separate sheet of popor,

In July 1969 Subject was transferred from fhe iCuba Settibn to the
Station froat office to serve a3 an executive assistant to the COS with
special, responsibility for ensuring that the paper flow of the Station
remainéd-under effective control during the period of transition re-
sulting from the assignment here of several senior officers. This
transition period necessitated or gave rise to a number of changes in
the management and adninistrative areas of the Station. Subject's }
performance in this assignment under these circumstances was clearly, .
outstanding. Her sound judgement, imagination and ~esponsiveness to’
guidance not only contributed to maintaining the stability and nomentun
of the Station but also made possible an early effort to come to grips
with many of the problems which an inflated Registry and a highly dis-
tinctive record; system created for the new Station management tean,.

During the. ensuing six month period, Subject has recommended and
implemented a nuaber of changes which have prodiced a more offective
and less costly records system. Paper holdings have been reduced sub-
stantially, input has benn rediced and now conforms to basic CS pro-
cedures and requiremonts. Personnel savings have been effected and
supervisory responsibilities more clearly delineated.

To sum up, Subject has mado and continues to make a major contribu-
tion in a singularly unsensational area of Station activity. Her aivic
is sought and appreciated not -anly by- the COS and myself, but by other
‘ ° : CONTINUED

SECTION D _ CERTIFICATION ANS 5 COMMENTS:
1" -

a (HAT TAY

BAND C OF THis EPO

DATE ~ SIG MATURE OF EMPLOVER
15 January 1970 _ 1 /s/_ Charlotte Bustos-Vidala
~~ BY-SUPERVISOR ~~ ;

2. — = - =o =
MONTHS TMPLO EF He sn BC Ere 1M Tes REPORT HAS NOT TEEN SHowh TO EMPLOYEE, GIVE EXPLANATION

UNGER MY SUPERVISIO

6 months _ . ven
a TYPED OR PRINTED NAME AND SIGNATURE

DATE OFFICIAL TITLE OF SUPERVISOR
15 January 1970 - DCS /a/ Paul V. Harwood _
“ ‘ BY REVIEWING OFFICIAL ~

COMMENTS OF REVIEWING OPFIciaL Tt would be difficult to overstate the contri-
bution made by Subject to this 3tation during the past six aonth
period, and I concur fully in the ratings and comments of the Rating
Officer, I might add that Subject is one of the more versatile,
conscientious and productive employeas with whom I have worked in
this organization, and that in adlition to the administrative/
management role outlined above, continued to provide valuable
operutionad/analylical assistance to the Cuban and other operational
sections of the Station. The inittative and imagination shown by
Subject in the very conplicated administrative management assign-
ment have been particularly commendable and her complete familiarity

i Phe coun untry, the language, and the backsroiun wind af the Statian

FE has been invaluable dating this “Pe PT of etd ns 67 £O “ANF ANG Stonaress

15 January 1970 cos | _/s/ James 8. Noland
SECRET

3.

14-0000

ee nme tee tenes ate ewe a, OF

SECRET/RYBAT
~2-

SECTION C NARRATIVE COMMENTS CONTINUED

personnel who appreciate her personal and professional qualities.

Subject is aware that her current assignment is an unusual one and
that she soon may have worked herself out of her current job. Since
she speaks fluent Spanish, ha3 a unlque ability to get along with
people and to get things done, there will be no problem in assigning
her back into a position more closely supporting operations. Our
operations are certain to benefit thereby.

SECRET/RYBAT


14-0000

Hptoce the lotter in the rating box carrespona:-3 10 ta satener,

{ONen Felted U-}
EMPLOYEE S91 RIAL NUMDER

. . Ma : q
. ; FID “SS REPORT 007667

GECTION Aer aa
1owaAME (Les (Fired) (Middte) 2. DATE OF DIRTH
BUSTOSVIDELA, Charlotte Z. | 12 Jan 29 Pe |

8. OF FICIAL POSITION TITLE %. OFF Div. OR OF H/ FF/ taeae cet |B. CURRENT STATION

Officer DDP/ WH/

D. CHECK (KX) TYPE OF APPOINTMENT 10. CHECK (KX) TYPR OF HEPORT

GantuarraguisionAy (Soe meirectione  Becion panne relate emreover

| fswacian (Speetty): | seucian (Specttyys

tt. CATE REPORT CUE IN OP, 12. REPORTING PERIOD (Pram to-)
October 1969

4. GRADE

March to Aucuct i 69
SECTION 8 PERFORMANCE EVALUATION

We Wook Porlormance ranges from wholly inodequote to slightly less thon sotisfectory. A rating in this category requires
> positive remedial oction. The nature of the action could ronge from counseling, to Iurther training, to placing on
probation, to reassignment of to soporation, Describe action token or proposed In Section C.

A- Adeqvota —- Parformanco meats of! requirement. lt 1a entirely sotisfoctory and Is choroctorized nelther by deficiency nor

excellence,
P+ Proficient Performance Is more than satisfoctory. Desired results ore being produced ino profictont manner,
+ Strong Porformance is chorocterized by exceptional proficiency.

O - Qutstending Performance is vo exceptional in relotion to requirements of the wark ond In comporisan to tho parfermance of
° ethers doing similor work a8 to warrant spectal recognition.

List up to six of the mow Important specific duties porformed during the rating perlod. fnsort soting lottor which best describes the
mannor in which employee parforms EACH specific duty. Consider ONLY effectivenoss fn performance of thot duty, All amployoos
with supervisory responsibilities MUST be rotod on their ability to supervise (indicate number of eaployece supervised.

specific purr NG! Until she was called to cther duties in the front ter rzn
office of the Station, did analysis on FHRUMEN targets of Staticn
interest, collated information and prepared studies, -peyc’ 19)
serciere Dury Hard ne TT ; ~ rere
re eG oP foes b 2 one ed ao patil oPeertes

. ww OPP ae EDs

and rreeeseed Intel idyence aus Operatacnel anformticn in close
tull time senior outsiie trenancribers whom

Shope natdg with tye
a) Vip se en a}
aPaciric SurT wo. S ~E0" : Choad ey Tat - 7 hee RATING |
Yancled the Station :BRUMEN watehlict and truvel ceTTeR
mation to UGrkst Stations and 3

prorrams end reported travel infor:
othes stomors,

eee Taind mnhenta 7 + RATING
Spaciric OUreNO* Provided operational suprert {file cheexs, opersticnal | verre
reviews, liaison memoranda, ete.) for varicus ‘tatica activitics. s

RATING

spEciric OUTY NOS (| ersten to the reparation of monthly summaries cverran

and project rer z (outlines, renewals, etc.)

2itbion Cerrar

cial projects for the ©tatden in

SPEGi#IC DUTY NO. 8

to her "hig 2
!
‘ _SVERALL PERFORMANCE IN CURRENT POSITION . _—
7a T Rating
Tako inte occaunt avarything abet the ¢-aplayeo which Influonces his effectiveness In his cuzent position such os pore | SETTER
formance of specific rything produc iwity, conduct on je> wt operarivese sa, portiner personal sraus of hal ts« aad
your Snan'sds. . analeses's overall performance duting the raring porisd, 0

porticuler limitations af talents. Based
Siew moat accutarely relives hia fevel of performonve.

aoe" 45 veq pagvious soirians SECRET

getter er riryerenmveriwe eowsrornmes reese ———

14-0000

CRET - '

. at (Then Fitted In) ——
SECTION C #0 MARRATIVE COMMENTS )

Indtcote significant strengths or wechnessos demonstrated in current position keeping in proper porspective thols valorionshia to
overall performonce, Si-te sugssetions modo for Improvement of work Petlormance. Give recommendations for training, Comment .
on forelgn language cu ee, Hirwsu'red 2: current position, Amplify or explotn ratings givon in Soction B to provide best
bosie lor determining fu. 9 personnel octivn. | poscel patlormonce of mono erie) ot supervisory duties und cost consciovsnge

3 f y F

ptheuse of personnelt03 . D iene
jaihe ottoch @ soporote sheet of poper. entre spose te Deeded to complete

Subject's performance continued during the period under review
to deserve high praise. Her enormous appetite for work, her
attention to detail, her ability to absorb and digest enormous files
and complicated cases, her professionalism and devotion to the duties
entrusted to her really deserve the rating of outstanding. Subject
speaks good Spanish, has considerable initiative, much experience
in analytic work and a genuine talent for administrative work.

In view of her past performance, her record at the Station and
her potential, Subject who was recommended for promotion to the GS-14

level should be promoted as soon as possible. .

a CERN TIFICATION AND COMMENTS ce venees vee eee
Bf CMyLOTRE ~ : a
Ot . 8, AND C OF mas REPORT

A Auzust 1969 _Charlotte Z. Bustogvidéla (Signed) ~~ ..
BY SUPERVISOR
IF THIS REPONT HAS TOT BEEN SHOWN TO EMPLOYER, GIVE EXPLANATION

MONTY EMPLOVEE HAS GHEN
UDR IY AUPER VIBIOM

OATS OFFICIAL TITLE OF SL PERVISOR TEPER ON FINE RD NAME AMD SIGNATURR

1 August 1969 Ops. Officer Francis Sherry (signed)

COMMENTS OF REVIE WIND OFFICIAL
4 %

Subject is indeed an exceptional ‘officer who is highly deserving
of the foregoing ratings and relseted accolades. In her new role as
executive assistant to the CUS ahe has teen invaluable during the
aéifficult “and complicated transition from the oli regime to the new,
and the related reorganization of uhe Station. ner organizational
abilities are unsurpassed by anyone known to the undersigned, and
she certainly merits consideration for early promotion. :

Sava T””CO*S OOF PUGIAL TITLE GF AE ZIEGING OF FIGIAL [PTPEG GA PRINTEO HAE AND SIGHATURE
1 August 1969 Shief ot Station | James BL Noland

SECRET


14-0000

- 7 oN . SECRET flaviewed by 8P/PD/EAB

(When Fitded In)

EMPLOVER SLAIAL NUMBER

FITNESS REPORT 007667
SECTIORASOOCtC~CS~S~SCSCSC~™S GENERAL
1. NAME (eet! iFeew (Middle) T OATE OF BIATH [9. 5EK 4, onaDe 8.30
Bustos-Videla, Charlotte 12 Jan 1929 F 'GS-13 D

6. OF FICFAL POSITION TITLE F. OF F-OIV/BR OF ASSIONMENT (€. CURRENT STATION
DoP/WH/A Mexico Cit

R TReseeye Uvemvomany | | raves L__]meassionment surenvison|
R-PROVIBIONAL (S00 inetractione » Section C) [xx | ANNUAL [ __[RACsONMENT EMPLovER |
A CC CC

12. REPORTING PERIOD (Frame fo)

11, DATE REPORT OVE HOR
January 1968 =~ March 1969
SECTION 8 . PERFORMANCE EVALUATION
W + flesh Perforwance tanges from wholly inadoquote to slightly less than satisfactory, A rating In thie category roquiros
pounve vesedial action, The nature of the action could range from counseling, to further tralaing, to placing on
Jon, 19 regEsignment ct to separation. Ovacribe action tekon or proposed in Section C.

A+ Adoavate Performance moote all requirements, It ts ontiroly sotisfoctory and Is characterised noither by doficioncy nor
- oxceltence.

P+ Proficient Performance Is mora than satistactory, Desired rasules are balng produced In @ proficient menner,
$+ Strong Perferrence It choracterizod by exceptional proficiency,

Pertorerence i3 $0 ancentional in relation to roquiroments of the work and In comporlion to the performance of
others ding dmilor work as te warrant special recognition.

PECIFIC OUTIES

O - Qutstonding

List up to aia of the most important specific duties performed during the rating porlod. Insert rotting lotter which best doacribes tha
manner in which employee periorms EACH specific duty. Consider ONLY offoctivonoss in porlormance of that duty, Ail employees
with suparvinory cosponsibitities MUST be rated on thelr ability to supervise (indicate number af amployoan auporviaed).

SPECIFIC UUTY No. t Cats
Handles Station PBRUMEN watchlist and travol program and reports
travel information to WOFIRM stations and other custumers Ss

sruciric oure No? Screens tho raw product of several technical opera~ {| S37iso"

tlons and precesses intelligence and operational information in
‘close cooperation with two full time senior transcribers whom sh 1)

chandles completely .
BPNCIFIC DUTY NOS ~— or Te —— ~ ter rine |
. . . . BR
Does analysis on targets of Station interest, collatos
infornation and prepares studies whe 0

APECIPIC OUTY NOLS Cetres
Contributes ta the preparation of monthly summaries and project
reporting {outlines, renewals, etc.) ; Oo

= a a

SPECIFIC OUTY MO. 4 Derree
Provides operational suppert (file, checks, operational reviews,
liaison memoranda, ete, for various Station activities Ss

SPECIFIC OVLY NOOO — — _— i oars

_ |
Ne i
ae ——-, et ee enh
7____QVERALL PERFORMANCE IN CURRENT POSITION _ ee _
RATING

Take lato aceouni over. thing vdeet Fhe omolowee abich inflvoncas his offectivgnest in his cirant positicn such ua pers | verres
farmance of soacific Gases mnigcevity, cardvet oo jab, couperutivensss, pertinent parsnnal traits ce hablea, arad

particulos Himitaticas cr falaeie. Based ra yc anv alotgs Of emplovse's overall porhaemance duting the ruting perlod, 0
ploce the fotter in the ratecg Bon goetaagsiniing forte atatawent which mon? ecawataly refisces bia level af performonse.|

wewernbemeee

Fate d
1. FA 2aM8
on AS @vtows woe

14-0000

SECRET

(Phew Fitted Ia}
SECTION C NARRATIVE COMMENTS «= .

tndicoto significant strengths or wecknesses demonstoted In current position keeping In propet perspective thelr relotionship te
overall performance. Store suggestions made for improvement? of work. petformonce. Give recammendations far training. Coon ent

Baste tr dersoateing Torcoo pos sonns ectbont Morey sfoensboroe ry el eens Aha ES ae given te Section B ye provide best
fib yeast ce Sedat ny Aes eft Tig po ee
Subject's performance during the period of over one year under

review continued to deserve the rating of Outstanding. Her major
contributions during that period were in the field of operational
research and exploitation of information obtained through technical
menns, She was, during this period, given full responsability for
the handling of two full time senior transcribers including adminis-
trative matters. In view of the difficulty of recruiting target
personnel] the task of fully exploiting information obtained from
technical sources is of great importance. Subject handled this task
with her usual enormous capability for work, displaying initiative
and great professionalism. She continued, in addition, to handle the
other tasks listed in this report together with sensative reporting
sent by a separate channel, altogether a much heavier workload than
is usually carried by one person. She was helped in this by her
good knowledge of Spanish, a talent for administrative work, con-
siderable analytic experience and great devotion to her work.
Subject should be considered for promotion to the grade of GS-14 at

the first opportune moment.

CERTIFICATION AND COMMENTS

SECTION D j
t, _ BY EMPLOYEE

~ CCEPTIPY THAT | HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT ° |
oA Led BSasyaruadt Of ERPLOTER

3 April 69 Charlotte Bustos-Videla -/s/_ _. a
. BY SUP ERVIOR 7

ee Ls

Guone ay SUPLAWISION Alba T fF Te NE PORT HAS NOT SEEN IOmN TO EMPLOYEE, GIVER RE PLANMATION

19 months |
OATE ™ GPFICIAL TITLE OF SUPER WISOR | TYPED OR FRINTEO NAME AND DIGHATURE
!

3 April 69! ops officer | prancis gnerry /s/___

BY REVIEWING OFFICIAL

1
CEaMENTE OF RE VIEMIAG OFFICIAL ~
Tho reviewing officor fully agrees with the ratings and coments

of the vating officer, Subject consistently porforms her dutigs in
an outstanding manner, bringing to her job truly exceptional
qualities of intelligence, reliability, and good humor. She is one
of the most valuable employees in the Station, and the recommendation
for her promotion from G5-13 to GS-14 is fully and enthusinatically

|
1
|
{
endorsed, |
i
|

ng ee oor a enemies er rr en repens aerate erp eee oan ae nye
Pore AA Tk FAI, TAFACIAL OPT EPED CA PRINTER Nave ast DIEM PORE

3 April 69 | cos, i Winston Scott /B/

SECRET Oo


14-0000

fant S-E-C-R-E-T pat

TRAINING REPORT

Sovict Bloc Operations Course No, 3 § ~ 16 Juno 1967

80 hours, full time

Student —- ! BUSTOS-VIDELA, Charlotte Office * DDP/WH :

Year of Birth: 1929 Service Designation: D

Grade — 2 GS-13 No, of Students 3 34

EOD Date > August, 1951

TNR mepRat eet en a mene na etna rman gute.
?

COURSE OBJECTIVES

ery

To orient the student on the special nature of the Clandestine Services!

Soviet Bloc target and to train him in the application of clandestine methods

i a : : :
for collecting information on, assessing, and preparing recruitment operas

tiona against Soviet Dioc personalitics,

ACHIEVEMENT RECORD

i This is a certificate of attendance, No evaluation tg rnade of individual

performance in tha course,

i FOR THE DIRECTOR OF TRAINING: ~
‘ i
a ed L if , ?
mae fe MEG ct 4C Pe bas Lie?
Rusdelt Al huntgchle Date

Inatructer, OTR

SAF oC oH -R eT


14-0000

. SECRET .

Odom Het tat fa) '
aes SMPLOYVEE SERIAL NUMBER
. FITNESS REPORT 007667
SECTION A GENERAL
1. MAME {Loot} (Piva) (Mtdtte) p2- CATE Gf @iMTH | 3. FEM 4. QGRAOe $.80
12 Jan 1929) GS-13} D

Bustos-Videla, Charlotte. |
& OFFICIAL POSITION TITLE 7. OF P1 ONT /OR OF ASTIONMENT /8. CUMRENT STATION
Ops Officer. : . _DDP/WH/1 Mexico City

@. CHECK OU TYPE OF APROINTMENT
x [eaneaw—[_[aesenve _[[eueanany | frssnean_____ ] 11 rensurarmen nuperaon]
CANeER-PROVIsIOWaL (Bee inetrctione + Section @) AK iameues «dd? =‘ AtNVONMENT ewPLOver |

1%, GATE REPORT OUE in 0.7,

29 February 1938

SECTION 8 PERFORMANCE EVALUATION
W > Wook Poslormance tongesd from wholly inodoquate to slightly less phon sottsfoctory. A rating In this cotegory requires
e positive ramedi al action. The nature of the action could ronge from counsollag, fo fur! training, to plocing on

probotion, to reasalgnmont of to soparation. Describe action taken of proposed in Section C.

A> Adoquata Performance moots all roquiremonts. It ls entirely sarisfactery ond is choractorizod neither by deficioncy nor
excellence.

P+ Proficleny  Porformance Is more thon satisfactery, Oosired rasuirs cre bolng produced In a proficient manner,

$+ Strong. —- Performunce ts characterized by excepticnal proficiancy.
O- Qutstonding Porlormance ts 00 excoptionoal in relation to requirements of Fhe work ond In compariton to the performance of
others doing similar work a8 to warrant special recognition.

SPECIFIC OUTIE

List up te on ef the moet Important specific dutios performed during the rativy pertod. Insort rating letter which best doseribes the
monnet In which employee performs EACH specific duty. Considar ONL f effectivenoss in perlormance of thet duty, All employees
with supervisory sosponsibifities MUST be rotod on tholr ability to suporvise “icdicate numbor uf amployece oupervised),

RATING
LETTAA

SPRCIFIC DUTY RO, I - yr
Handles Station PBRUMEN program (maintains a watchlist, sereons
travel documents and reports travel information to WOFIRM stations

and other interoasted customers),

teen ne ee te me ETNA

SPECIO IS Quit Ma, 2 lerree

Screens the raw product of technical operations and processes the

intelligence band operational information, 0

SPECIFIC QUTT 40.3 ee a, ou ~ aa Tie

Does nnalysis on targets. or Station interest, pulling documonts °
19)

together, collating information and prepzring studies.

. fr aera
alae FETE. fhe preparation of 1 month): : ‘a ;
: a tt Stisma x
reporting (outlines, renewals etc, ). , fea and project

SPECIFIC OUTY NO. B a
Tie —

Provides operational su ¥
pport (file checks, operational
iiaison memoranda ete, ) for various Statton ac tivities. en

BATING
bet ITEM

ye .
32) . ;
fs
OVERALL PENFORMANCE IN CUR CURRENT POSITION

who Into aesaun ne de try Bboy: Lal @ which Intluencas hie Tevare #9 fwvrant postion such a3 sore
T 4 ty BE, bout the omployo. hich tnth, hie effzes, h $ h
formancs of apecific wtioe, productivity, Cenduct en sad, FOCPH A vorwas, pare Bersanal teaite of habeas, and
Ser san.
partie ylus limitetiona st igiedta Nerad on you knoelaige of eeplopes’a seerali cer formonen dazing tha pati ing Period, 9
ED HS te » a) i My 1D S0Otawert azhich eoasa Tew eles, sellacts bia I 1 of partvesance, |
a cs ries tn tha ral, bon terre spendin tee rt ante bh a ove’

fleviawad by ey a
= L. | nk

ner rr :
predcresc DUTT NS & a Ne tnt te

ot eran pie rn etree

Foam

e-a8 43 MIE PAM siSya Corrine SECRET

:


d

\ SECRET
. (whan Filled Ta)
NARRATIVE COMMENTS «op a
ing in proper perspective their rotutionship to
Give recomn ondarions for taining. Comnent
$eetion B to provide boat

SECTION C

Indicate significant strengths or weotnecs

overall gerlormance. Stote suggestions ma
on foretga tangusge competence, if raqvired for currert position. Amplify or explain ratings givan jr
Loe: Qaies ond cost conscion

90 demonstroted ia current position keep!
do for improvement of work performance.

bois for determining future personnal octlon. bis er_of patformonce of mosppett gl or igh tal y is needed ta i ‘e
be eatea tpace id complete

j nthe use.of personnel. spas @oY wf Ferd : +
Since: her: arrival at this Station, Subject's performance has truly been
cutstanding. She has, on her own initiative, reorganized many of the
operational files and procedures of the PBRUMEN Section. She has made
particularly useful exhaustive analyses of the documonts concerning a
number of Station targets not only per request of this Station bit also
on her own initiative, She has revamped the Section's travel progran,
curtailing the watchlist to moro manageable size and expediting the

for such informa~-

reporting of travel information to the many customers
ke of several technical operations

tion. Her thorough review of the ta
has incroased their usefulness as.wall as emphasized thoir weaknesses. .
OUNGE Ce LU BIOMOL Z ETON, CE EUSA TUTTO G CS adae tatant for adainistra-
pion, her initiative, sharp analytic mind and good knowledze of Spanish
gave greatly facilitated the oporation of the PBRUMEN Soction of this
spation at a time of almost complete personnel change. She has not boen

rectly involved with the actual running of oporations both because
she appears much better suited for the support type work intrusted to
hor and because ste frankly would not have the timo under present

3% es to do go, Subjoct is carryin

handled by moro than one person, ~ ying the workload usua}iy

“CERTIFICATION AND COMMENTS

"BY EMPLOYEE

SECTION D
i -
| CERTIPY THAT I HAVE SEEN SECTIONS A, 8, AND C OF THIS REPORT

BATE sigma Tuns OF EMPLOTER

16 Jan, 1968 /s/ Charlotta Bustos~Vidolta

2 eae nena Se
7 AY SUPERVISOR
MONTHS EMPLOYED NAT AE roneiaren ee
UNDER My Bubs ation rT) Te THIS PH PONT HAS NOT BEEN SHOMN TO EMPLOYER, GIVE EXIMLANA TION

5 months
Dave “TGP PIGIAL TITLE OF SUPENVISOR TTPED ON PRINTEO NAME AND SGHATURE
W168. Jan _igsa___| ops ores
se, s teer rancks err:
3. ce OY REVIEWIHG OF FICIAL ” nels Sherry

COMMENTS OF AEWIR WING OFFICIAL

The Reviewing Officer fully concurs in the evaluation of Subject by
the Rating Gfficer. Subject consistently turns In a super lor
performance, whatever her task, and for a Station Chlef che enly
problem she presents is to determine where best to assign her. she
Is a source of strength to her Sectlon, has the knack of making
herself irreplaceable.

OaTE [erence TIFUS US RE VIE @ NG OF FICIAL "yrrPap UR PainTeD yard OND 5° GNATURE
. {
17 Januar 1968 i Chief of Station ! Winston D. Miller
ane ere eanenneeeen een arene : 2
SECRET )

14-0000

. : so ‘ SECRET.

CMden Filtiad Ta}

EMPLOVESR SERIAL NUMBER

y
oo76s67

FITNESS REPORT
— GENERAL

(hoot) (Fivet) (ateatie) 2) OaTe OF GIRTA 1D. SEX

., Bustosvidela, C.Z, Jan 1929 F

OOF PICU POSITION TITLE

Ops Officer

% CHECK Im) T¥PR
KX [canwea

4. 0RAOE

| [REASSIGNMENT SUPERVIZOR
| | RAR ASSIONMENT EMPLOYER

PROVISIONSL (Seo InsInuctions = Section C)

(Spectiy)i 7
ATE REPORT OVE IN O.P,

31 Jan 67

12. REPORTING PERIOD (From: to-}

1/66 - 12/66

We Wook Porlormance ranges from wholly In wate to slightly less than satisfectory, A rating In this cotegory roquiros
positive remedial action. The nature of the action could range trom counseling, to further training, to placing on
probation, fo roassignment of to separation, Describe action taken er proposed in Section C.

Performance meats oll requirements. tt is ontircly satisfactory and Is characterlzed nolthor by deficiency nor

| A> Adoavate
excellonce, .
P+ Profictant Parformance is more than satisfactory. Desired results cro being produced in 9 proficiont manner,
S + Strong Perlormonce ts chorocterizod by oxceptioncl proficiency, .

O+ Qwtatending Performanee.is so exceptional in ralation to requirements of tha work and in comporlson to the porformonce of
others doing simifor work as to warrant special recognition,

PECIFIC DUTIES

Liat up to gix of tho most Important spocifie dutios performed during the rating period. insect rating latter which best describes the
mannor in which employee performs EACH spacific duty. Consider ONLY offectivenesa in performance of that duty. All employoas
with supervisory responsibilities MUST be rated on thoir ability to supervise (indicate numder of employece supervised).

SPaciric GuTT NO. T Handles all aspects of 22 FI/CE/Support projects
including project actions, logistical and financial support,
requirements, guidance and review.

RATING
LEYTER

to these projects Lneluding field agents, Coutract, Career, and
Start Agents, travel; Oo

This includes OA/CSA's, contracts, training, ;

cover and funding.
RREGIFIN CET NO} Dyepares, or holps prepare, miscellancous memoranda Roto
and studies, such as monthly FI achievomants, oper:tional program, |

bude resnons6s to requests’ on operations or re)
back »MOXACO, come need

SPLECIFL
Routes correspondence, supervises tickler system,

maintains project, agent, and subject 201 files. . g

SMETIFIC GUTY MO. 9

Branch records officer.

Coury yo. 8,

tt eo! -

en, OVERALL PERFORMANCE IN CU _
So TN dee PEA } Raving
Paurerray

Teka sta aczount acerything shout the cmsiozeg which Influences hia allactivenass in bys evérent position auch os pare
‘

formance of spectre dution, grichurtiecty, conduct on rch, cooperativenast, pertinent gersoral fulta ce habers, ond
particular essatiany ce talante, Boced on yout Ssaelodge cl orginyee's overall paris. marca during the tating period,’

plese the lartcs ta the eating bea canes geciding ta tha Hulomont whieh mast veeuately tofiecta nia level of por formance.) s

t

'

See se ae
sean oe

aie SEL TOS SE Tete rt a SECRET ees


14-0000

Uren tr ors Red hick

SECRET

(fhen Filled In)

SECTION C NARRATIVE COMMENTS Fig if 1

Indicate significant strengths or weoknossas demonstrated in current position keeping in proper 18.416—0-3 rh Ave inele ralotionship to
overall perlormonce. State suggestions made for improvement of work porfarmonce. hive racommaendations for training, Comment
on foreign languoge competence, if required for current potition, Amplify of explain ratings given in Section B ta proride best

basis for determining future personnel action, Manner of performance of managerial or su. s trios must be doeczrbed, if
spplicable, gettal of SURPAY LY Sey

Subject has continued to. perform during the poriod under
review in the same highly competent manner which all who know
her have come to expect of her. She continues to put forth her
best efforts at all times. . She is particularly to be commended
for the manner in which. she cheerfully accepts onerous tasks,
usually with very short: doadilines, and invariably comes up with
‘a thoroughly prepared answer within the time allotted. She is
efficient, she is fully knowledgeable and capable in her job, she
has a friendly, warm, and pleasant personality, and is always
ready to respond to her fellow workers with a helping hand.

She has. no supervisory responsibility per se,. but is frequently
called upon for guidance to new secretaries and case officers
alike and is of real help in such cases. Subject ig one of the
strongest Headquarters case officers known to rater, and her ,
overall performance certainly borders very closely on being

evaluated Outstanding... a

SECTION D CERTIFICATION AND COMMENTS —
’ - BY EMPLOYEE co

_ 1 CERTIFY THAT 1 HAVE SEEN SECTIONS NS A, 8, AID CO OF F THIS R REPORT
DATE 7 OT TRIGHATURE OF EMPLOSER
- ii a | a, Pa 4 +
nether Oe CfLie weet i ai aan

BY SUPERVISOR _ _
We THid ACPORT HAI NOT GEEN “SHOWN To EMPLO TEE, IVA EXPLANATION

: PHS EMPLOYEE HAS DEEN
VNOER Mr SUPERVISION

18

Ver riciAL YTLE OF SUPERVISOR

i
3.
COMMENTS OF REVIEWING GFFICIAL

DATE

20 January 1967

___ BY REVIEWING OFFICIAL a

Concur. An outstanding officer recognized as such and
appreciated by all.

Gata oe oe en Torriciat 4 TILLY OY REVIEwING OFFICIAL (TYPED OR PRI SPW reer

31 January 1967 | C/WH/T i We J. Kausman

;

SECRET

14-00000

. ‘ ‘SECRET _

* \ (pnen Filled: fn)

EMPLOYED JGHIAL NUMBER

007667

FITNESS REPORT

Vowame (Laat) ~ (Firat) (Mtadie) sad. DATG OF Bint [3,5ER
BUSTOSVIDELA, C, 2. ! A2 Jan 29 {| FF }GS-12 |
nw OFP/OW/ER OF ASSIONMENT |8. CURRENT STATION

6. OF FICIAL POSITION TITLE

ope /WH/) Headquarters

RE ASSIONMENT EMPLOVER

CARE RM PROVISIONAL (See inatructions + Section C)

[~~ TarweracGreciins d

11. DATE REPORT OVE IN O.P,

12. REPORTING PERIOD (From: to)

1 January - 31 December 1965
_PERFORMANCE EVALUATION

SECTION 8
W Weck Performonce rongos fram wholly inedequete to slightly loss than sorisfactory. A cating In this category requires
. positive remedial actlon. The nature of the action could range from counseling, to further training, to placing on
probation; to reassignment of to soparation, Deacribe action taken of proposed in Sactlon C,
quiramonts. it Is entirely satisfactory and Is charactorized nolthor by doficlency nor

A> Adequate Porformanto Insets all ro

excellence.
P+ Proficient Parformance ts more than satisfactory, Oesirod results are baling produced in a proficient manner,
S + Strong .

O + Outstanding

Portormance Is charactorized by oxceptional proficlancy,
Porformanco ia s0 exceptional in relation to requiromanta af the work -and in comporlson to the porformonce of
othors doing similar work as to warrant spacial recognition.

_——- PECIFIC DUTIES

List up to six of tho most Important apocific duties porformed during the roting pariod, {nsort rating latter which best describes tho
manner in which employee performs EACH specific duty. Consider ONLY offoctivenoss tn parfarmance of that duty. All employoos
with supervisory responsibilities MUST bo rated on thale ability to suporvise (indicate numbor of amployeys auporviaed).

SECC GUNS Handles all aspects of 22 FI/CH/Support projects | RAFT
including project actions, logistical and financial support,
requirements, guidance and review.

we an eee on ~ Td hatonodup Fa PRATING

srecieic oure sa Handles all matters concerning the agents bolonging to | FATRG
these projects including field ageuts, Contract, Career, aud Stali
Agents, ‘this includes OA/CSA's, contracts, training, travel, cover! 0

fad. LUN ADS ee ee pe ee ee ee
specieic oury NO-3 Prepares, or helps prepare, miscellancous memoranda !
and studies, such as monthly FI achievements, operational proyram, i
responses to requests on operations or background

{ RATING
; LETTER

budget exercises, s
Anio regarding MOX8CQ... no een
sreciFic OuTY NO.4 POutes correspondence, supervises tickler system, l tester
maintains project, agent, and subject 201 files. Ss

| RATING:
pRETUIER

SPECIFIC DUTY NOS

Branch records cfficer.

ce er eran een ee ee em mn arn eae ne eat ne et

SPARCIFIC DUTY NO. 4S

ES TRA TING
ant Poasston silos pore | LETTER

*
Take lota eeceunt sverpthing ubout the amployoe which inlluences his cfortiverays in hia gure
formance af spqcibic duties, preductivity, conduct on job, cooparativensss, pottinea? sarsonal tata os hebits, and
particular limitations of roleats, fased en your krowladge of wmployen's overall performance during the rating period, oO
place the lerter inthe reting box correspending to the statement which mast eccutatoly raflocts his laval of pasfarmance. !

25 GAN BSSS—7 |

yore 45 osspter. previous doitiens. SECRET


14-0000

SECRET

(When Fifted Tn)

SECTION C ’ NARRATIVE COMMENTS OFFICE OF PEL SONNE
indicate significant strengths or woubnassos demonstrated in currant potition keeping tn proper paropactive thole relationship to

overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Comment
Amptly of axptuin rutings given in Sectton B to provide boat

en foreign language competence, i reavired for current position, , j y eee
a erminin: LY lon, rm monageri ul Obri wt ribed, i
opelices! var ining fulvee personnel! action, Manner of petfurmance of managerial o: ant a aed a id
Subject continues to render a suporior performangm, anfibe is
efficient, thoroughly knowledgeable, rapid in her work, well
organizad, and greatly facilitates the smooth functioning of
the office. The quality of Subject's work has been recognized
fully in previous fitness reports and in previous recommendations
for promotion from GS-12 to 13. -This high quality of work has
continued throughout the period of this fitness report and

' Subject continues to merit promotion.

-
. ‘
' ‘
f t
, 3
SECTION D ____ CERTIFICATION AND COMMENTS " cee
LA eee pee eee _. _ 8Y ! EMPLOYEE | cee concn ne pte eee soe a parin wsnnpnnane ae
. fc RTIFY THAT. MY HAVE | SEEN SECTIONS 1 A 8. AND C OF THIS REPORT
BAT THON ATURE OF PU LOYRE ——— — ——
‘ 4y. wt ’ 2 oe
Jee ae ; wks:
2 ‘ he
[MGHTHNT EMPLOYER HAD OCEN he THIS REPORT HAS NOT DEEN SHOWN TO EMFLOYRE, 17h 2XPLANATION ~ _
UNOEN MY BUPENVISION 7
oe a
._ Four __ a spina ee gg peers Heer pena Eh —
OATa OP FICIAL, FOE OF SUPERVISOR TYPEO OA Pat 2, LA, ie “ino ES WATURE
1,0. wt Fiat Mb th hg
6 Goan. %7e DC/WH/1 ae SG evi f Lae
BY REVIEWING OFFICIAL . __

3

COMMENTS DF REVIRWING OP RTRIR tt RS II
‘ " i ot Gg

Reviewing Officer agrees with above report and endorses

Subject's fitness for promotion.

aaeame eammmmnt< tie Srcates Se, ee po ne eee er acne ee ee ref
DATE feo Tyee bat Torrician t TITLE. OF "REViEwsG OFFICIAL [yVveeo. Oat PRsuTen prrrrs AND SIC a TURE
Ete Ma fo

WJ, Kaufpay” a

C/WH/1
penchant

> : SECRET

14-0000

‘ SECRET

bd {Bren Filled in)

EMPLOYEE SEHIAL NUMBER

een corey @

FITNESS REPORT

GENERAL

"T"[av gare or gin TM ]% 8ax

SECTION A Z
1. NAME (La (iret) (Mrding
suntoseVidels, Charlotte oe

oe arent a te
©. OF FICIAL POSITION TITLE

Doe and
"OQ CHECK IX) TYP OF REPORT

. REABSIONMENT SUPERVISOR
REASTIONMENT EMPLOYER

6 OF APPOINTMENT

" I [acvenve I I TEMPORARY
KALPROVIBIONAK (Seo matmuctions » Section C) ~

trectan ( Spectty):

11. DATE REPORT OVE IN OP,
21 Jaruarm 165

sracian (Specify):
AR REPORTING PERIOD (From tov
2 January 12¢h = 3) December 1944

SECTIONB PERFORMANCE EVALUATION
We Waok Porformonce ranges from wholly inodegvate to slightly leas than satisfactory, A roting tn this category requiros
positive vomedval acilon. The nature of the action could range trom counseling, to further troining, to plecing on

probation, to reassignmont of to sogaretion, Describe oction taken or proposed In Section Cy
Performance meets all roquiramonta, tr ia ontlroly satisfactory and Ja characterizad noithor by deliclancy nor

A+ Adeavara

excollence.
P+ Proficient  Paorlormonce is mora than satisfactery, Desired results aro being produced in a proficient manner,
S + Strong Perlormance is choractorized by exceptional proficiency,

O- Qutatonding Parformance ts 80 exceptional in relation to requirements of the work and In comparison to the performance of
others doing similar work as to warrant special recognition. ~

SPECIFIC DUTIES SS OCOOCCSSSCSSCSS

List up to atx of the most important specific dutles performed during the roting period, Insert rating letter which best describes tha
mannoe in which employee performs EACH specific duty. Consider ONLY offectivenens in parformance of that duty. All omployoos
with suporvisory rasponasibilities MUST bo cated on theie edility to supervise (indicate numbor of employeos auperviacd).

aerciFic Buty nas . >
Prepare, or hélp prepare, miscellancous memoranda and

studies, such as monthly FI achievements, Operational Program,
respenses to requests from the Senior Staffs on operations uad on ; °

Mex co —b-tsed-fy-——----- Bere meee “ . ae
seeciele Sure hod {LETTER
Suporvise one Intelligence Assistant in the maintenance of a desk

tickler system and the agent and subject 201 files at the desk,

Teecwic SuTy Nod ~ aa oo ne Rare
Handles all aspects of 21 FI/CE/Support projects including project!
actions, logisticat support, requirements, guidance, reviews. 0
PEGIBIC DUTY "and le all matters concerning the agents helensing to [eran
these projects, including fiold agents, Contract, Career and Staff!
jf Agents, This includes OA/CSA’Ss, contracts, training, PCS avrange-|
JONES, cover, unding, ——~-—: .-_ nO ee
; wetter
I
i

RATING

SPECIFIC DUTY N

Records Officer

ATING
LETTOR

infiucates Sis clisctiveness in his current position such os pare |
formance ef specific dutioa, crodvetivity, conduct b, cascorsiwesess, pettinuat potsenul trains or habits, andj
particular Heiratiqns cr relents, Based on your knowles of omployoe's overull performance during the rating period,| re)

place the forter in vie bea corresponding to the atatereny which most accurately rotlocts his lavel of perlormence.
ope sas
wi ONS,

Yoko Into account every ung abet tha omployeo whic

y

wd fh
. 4 .
asi" 45 vosccets wae .tous eaiTIONE, SECRET

14-0000

SECRET

(theo eit fed tn)

SECTION C eee
Indleate olgailirant strengths or weakneseon demonstrated in current position kaoping in proper p sbecttyg thelr ralationship to
ovacall perlormancy, State suggestions made for Improvement of work performance, Give recommendstions fratalny. Comment
on foreign language compotonce, if raquicad for current position, Amplify vo onplatiyset ngs given in Section B te provide bost
beets for determining future personnel octton, Manner of poclormance of monogerial"A supervigory dutias myst be described, If
Pe this exceptionally competent and productive off déerecont inued
to perform at a level well above that of the GS-13 slot*she occupies.
While a good deal of her tremendous effectiverusg, stems from
experiance, continuity on the job and her natural ‘fetentive memory,:
during the period under review she also demonstrated a flair for,
and applied her talents to, the solution of relatively major and
complex planning and managerial problems in the area of operational
Support to Mexico Station activities. .

To the list of. her previously abudantly acknowledged capacity
for hard, effective work; talent for training on the job younger
officers, diligence, and versatile ability, this rater would like to
add a note of appreciation for her everpresent tactfullness and
discretion. No weaknesses affecting her present assignment have been
noted; she is very careful and realistic in planning for expenditure
of funds, - “3

This officer is separately being recommended for promotion to

GS-13, .

WH will review tats fitness report with cthers during a scecial meeting schedul
periodically to consider suitable recomeniation for outstanding performince.

CERTIFICATION AND COMMENTS
”_BY EMPLOYEE

THAT 1 HAVE SEEN SE: A, 8, ANO C OF Thi
DIGHATURG OF RMPLOYKR

an aero rr ar th Ste
ae a a Ce ene ae

pa ei
¢ SUPERVISOR’
30 he Tid WEY ORT HAS HOP UREN SHOWN TO PMPLOVER, GIVE EXPLACAVION

MONTHS BMPLOY:
UNO ME SUPER

Gate ne cal ee Se | PRINTED NAME AND BIGHATURE
- ‘.

weep 2 Bat | NC/WH/1 __|_jAlfonso Spera
"BY REVIEWING OFFICIAL __. _ __

3

COMMENTS OF REVIEWING OFFICIAL

a

van
_ _—_—--- wees anne wage ee eee
PEO OR PRIN owe € UAE
Frret Pe pT iy NAME aw SIONA Tat

FrocIAL TITLE OF REVIEWING OF FICIAL,
Ph erg e

oO

SECRET


14-0000

: wr 7 SECKET _

CWhea Filled tn)

EMPLOYER SEAIAL NUMBER

a] .
oy FITNESS REPORT . 007667
SECTION A GENERAL a
1. AMR (Laat) (Fire) (Middle) 2. OATG OF BIATM |, SEX 4. grape [8.50
BUSTOS-VIDELA, Charlotte 2, 12 Jan 1929 _| GS-12 D
8. OP FICIAL POSITION TITLE . 7. OF F/DIV/BR OF ASSIONMENT (8. CURRENT STATION
Operations Officer DDP WH 3 | Headquarters

9. CHECK (XM) TYPE OF APPOINTMENT 10. CHECK (XD TYPE OF AAPORY

canean [__[ntecnve[[reuvonany [Trae
: s

PROVISIONAL (See inatructions = Bectian C)
| fomacian (Spectty)t
11. CATE REPORT DUG IN O.P,

REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOVER

beaciac (Speotty):
18 REPORTING PERIOD (From: to-}

1 January 1963 = 31 December 1963

. 31 January 196)
SECTION B = PERFORMANCE EVALUATION _-
W- Wook Porformance ranges from wholly Inadequate to slightly less than satisfactory. A rating In this category requires
positive remedial action. The nature of the actlon could range fram counseling, te further training, to placing on

probation, to reassignment of to separation, Describe action token of proposed In Section C.
Performance moeta all requirements. It is entiraly sotisfactory and Is choracterlned neithar ad deficiency nor

A> Adequate
excellence.
P+ Profielong  Porformance is more thon satisfactory. Desired results are being produced ina profielont manner,
$+ Strong Performance Is characterized by oxceptional proficiency.
QO > Qutetanding Performance ts 10 exceptional In ralation to reaquiramente of the work ond In comparlson to tho performance of

others doing similor work os to warrant special recagnition.
PECIFIC DUTIES —
List up to Bix othe most Importont spocifle dutios porformod during the rating ported, tneart rating letter which bost describas tho

manner in which employee porformas EACH specific duty. Consider ONLY effactivenose in performance of that duty, All omployees
with Supervisory rosponaibilittes MUST bo rated on their obility to supervise (indicate number of omploysos supervised),

SPuciFic DUTY NO, — ~ — TA TINO
Handle Project action, operational correspondence, support for 19 keryERa
FL and OPs Support type projects, offecting proper coordination with senior 8
staffa, other divisions, and offleas.
SPECivic DUTY NOR ee -_ RATING
Handle clearance actions, contracts, end administrative matters for agents terre
fe)

falling wmder these projects, and for the entire Meek in ths absence of the
Intell Analyst.

|
|
'
{
i
v
SPR CINIC DUTY NO. 8 T r

i LETFER
1
|

i

ny
Pre para - ‘miscellansous ‘senoranda, budget, and reports requested by Senior
Staffa ahd “Bivialon ofnNcers fron the Mexdiean desk on Mextoan matters in 3
peneral, -
SPRcvIC “Bury NOL ra ee ee TT penn rrr rer i 8 oa "RA ory
Supurvise the clerical and administrative peraonnel on the deek (averawing h) werren
pnd in general.sea to the smooth functioning of the desk and the flow of Papers ce]
Speciic DUTY No.8 om rrr ir manana TE RATING —
Reconls Officer for WH/3/M - 2p RETNE®
, CG
gpRcwic OUTYNO.4 ne TST
Agsus: the responsibilities of C/#i/3/4 when the Chief of the desk is absent, 1 °°77""
sipning dispatches and cables, coordinating, and aupervising 2 Reports Officers} P
and 5 Case Officarsae dt
__ OVERALL PERFORMANCE IN CURRENT POSITION _ _
Ing

. ¢
Taka lato arenunt ower yihlyg abour tho employs which Influences his effectivanoss in hha currant position such ad pare { LETYEs
formance sf spocitic Jitter, Productivity, conduct on jub, cooperativenes:, portinent personal raiser habits, ond 5
pertleulor limitarions ov tulanis, Based on your kAnuviades of omployve’s overot! partoemanca duting the reting poriod,|
plaga tho letter in tha fue bex covreapending to tha statement which most accurately roflects hie lave! st partermance. 4 = Gy

14 rcs 354. :
errant enatreneennren ta enermeereecntimenmmnenl rau
Pom 46 onsck ere PAmeioUs RUT CnS SECRET a

aez


14-0000

SECRET

(When Pitted taj

SECTION C NARRATIVE COMMENTS
tn propor perapective their celatlonship ta

indicate signtlicant strangthe or weaknestas deamonsteated In crarant pseition keagin:
avecall porformonsa, State suggestions mode fur improvement of work sarfaemance, Give recommendations fur training, Comment
on foivign longuage competence, If required bur current position, Ampidy ov exploin ratings given in Section B te provide best

basis for determining lute Personnel oction. Manner of porlormancs of panagarinl of 1. 2upetvisery dutios must bo described, if
syzlicable,

Subjoctia pérformanca during the rating period has been sarked by general
excellenvs, As indicated in Section B her supervision and direction of the Ssction'p
work releting to intel aupport, administration, preparation of special reports,
training personnel, atc. 1a uniformly outstanding. Tho fact that thase functions
are handled in addition to her duties aa the desk officer for the FI and Ops
Support projects, which she performs with unusual competence, servos to illustrate
her -valua to this Section. She has an axcaptional ability independently te
determine proper courses of action and to initiate action to carry them out. She
hae a profound understanding of the area operational program and contributtong ‘to

4t are imaginative and conatructivos

In the opinion of ths rater ‘Subject!s performance compares favorably with

any (6-13 desk officer within his experiences end she performa occasionally at the
GS-1) level. Moreovar, she carries out her duties cheerfully, loyally and in
close end amicable cooperation with her fellow employses at all levela.

In those aspects of her duties which involve cost e. g. tho“review
.of operational projects, she has given close attention to the
budgetary matters and has frequently suggested ways in which
economlos An the operations might he effected,

SECTION D CERTIFICATION AND COMMENTS —

; . BY EMPLOYEE ee
en __ __ECERTIFY 1 THAT T HAVE SP EM LECTINS A, 8, M12 © OF THIS REPORT _ — ~
ware feIGuATURE OF “EMP Lover
28 Jenvary 196! 196k | Cle wen ihe 7 for
— _ BY SUPERVEOR
HE THD Be eon T HAS HOT GERM Sea T fd UMPLGVEE, GIVE EXPLANATION Seeman

oree 88 | Bie a

mee re anmecntnes cnerneen aero _ cee ce eee ee ee meng
ir? pe oR printyo & NAME y zs a ug
E. Keel

pate ; [QP PICIAL TITLE OF SUPREVIBON i
- ! (AE ¢, eae th. ©
At 2 hr fo C/8/3/ Ye xico i: fernard Re. ioictnaral
L ” “AY REVIEWING OF GrFiciaL
—_ REVibwinG OFFICIAL. ee
| I ceacur in the high rating given this employee. She 1a undoubtedly
the ublest exoloyee tu this branch in the performance of her particuler
jod,
:
GSE Tren en SEAL TITLE OF REVIE SING OO PITAL TYPED ORL AGINTED NONE AhG SGNATUCE —
t H . .
29 Jan 16s C/wH/3 | ott Gna

SECRET l/s


14-0000

(eh mie . La

EGP Gh VWs web PG ae TEPC AUD EXPORTEPCE ° .
. gw

oweia

a The eatcgory checked Below ix oun inter: scores mada by the

srson nancd above on a battery of fered 1 testa, The relations

hipa betwen test porformmanes and anbsooucnt meenee Of trainecr in

Rancy language tratnines courses are dadteated bey the “eran one next “th tt ‘itude 0

sntugorics. The graphs to the lett are for vaiva and the traphs to the r

‘armen. Fran these pranhs you can read for cach aptitude catorory tne trvbe

wbility that ajerson in that catcsory wlll perform in an Agoney foreign Lanimage

“Paitning course ot an average er bet boretuinesverase level. For example, 72 per

tent of the women who obtain an tiutude rating of “B" oan be cxznect.d bo Le

“Verage 9r better in course performance, while S per cont of the men with ratings .
i af "3" can ve capeeted to be Avorn OF Leblor an course perforvince, A san needs
i in Aptitude rating of "Ol" te hove svoub the sans uxpeetation of suceuss in j
H vanguaye traindi as a woman with a rating of "3", At the otlur end of the scalo, f
: OQ per cont of cithcer non or vowten who obtain on tA tule ratings of "2" can bs -
i oxpected to do avcraye or bettcrethineaverage work fn traininz, The alffereneces
5 in relationship are duo to differences between men and vomen in both traizing “4
: yerfommance and test scores, Om ths average women aro gomovhat higher on toth, aa
i
i Porecnt of Wonen Whose Language rerecnt of Men Whose Language ‘
| “raining Performance Is Expected Training Performance Is Expected i
! to Be Averazo or Bsttur than Aptitude to He Averago or Better than i
: .Verayve Catepory Average :

{90 8S 8 mad 0 9) 3) :

Ty Anny meen an

- j :
. A
'
Since moiny--Lhines ather than 4nte the detorminatian wT train
ADR Course perfomance, in anys cla there will uoually ne tees “nose
sopformance wala be bebbor thap would bo ted “ron their ton
there will . kely be see whose .
Vartye PLOW, Rui TLPLRTS i hy and ot!
sensteered Gp selecting topic fe nz and in inte
: i 2 renulls, for oxempie, th
band the amount of acadimte ant
acters pet Sagurecd by the testes
feanaine 4a We auhethor sueh e dence was in
ior in 2 Gillercut ove is, of course, an addit dont
. __. forcien Languages have bech stédied er luerned by this indiviaual. mee

eek eokeat roa :

= “FSpert may BE

“noun to the yd fy Tenaga A, weemauisl

Viduel cone srned

Widus) sone mrecda | ermeiaahe ta ate alae Sop, RIPE Troncbeee woe
Lit tat 4 he aoe

o>

wt .

i.

te

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i

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14-0000

‘NRCan sepretige anda mmmene tt

IRI eR Te et mney

apres

SEORET
TRAINING REPORT
RECORDS AFFICERS COURSE O April - & 1
Student ? Charlotte Z. Bustos-Videlpfiice 2 wH/3
Year of Birth: 1929: Service Designation: p ;

Grade. 2 GS-12 Numbor of StuAents ; 3h

EOD Date 3 Aug 1951
COURSE OBJECTIVES - CONTENT AND MATHODS

This course, designed for present and prospective Records Officers, |
has four principal objectives. . :

1. To give an approciation for the Agency's CS mission.

2. To describe the role that records play in the discharge
by the Agency of the responsibliities inherent in the

mission.

3. fo emphasize tha importance of records and proper records
managamernt in the successful performance of the stated

mission,

4, fo dnsvease avaroeness ot the tuter-rclationsnips between
the C3 mission and records; to sharpen judgement in the
handling and @lgposltion of rusords; and to improve por-
formance oF Rucords Orrtears.

The student ts Lnstructcd through tho media of lectures, directed
rerding, practical exercises and dlscusslons,

ACHIEVEMENT RECORD

This 1g a certificate of atteniunce only; no attempt was made to

evaluate student achievement in the course,

FOR ‘ims DIRECTOR OF TRATIING:

, /.

LL CAL —

Hdl SMia¢

yi Augustus F. Scherme shorn 2h Judy 1962
Chicv Instructor Date

-

14-0000

ss SECRET :

(then Filled In)

EMPLOTER SERIAL NUMBER

FITNESS REPORT POtEEF

SECTION A _ __ GENERAL
TT NAME (Law) (Firat) (Middte) {2. OATH OF aIntH [2. BEX

_Bustos-Videla, Charlotte 12 Jan 29

6. OF FiciAL PODITION TitLe

__OPS_OFFICER

9 CHECK (KD TYPE OF APPOINTMENT

CAREER [ RESERVE [ TEMPORARY

CARZER-FPROVIBIONAL (See ineiructions + Section C)
IAL (Specify:

19.94 ORT OVE In O.P.
31 January 1963 :
SECTION B PERFORMANCE EVALUATION
W + Wook Porformance ronges from whally Inadequate to slightly less than satisfactory. A rating in this category requires
ether training, to placing on

positive romedial action, The nature of the action could range from counseling, to fu
“probation, to reassignment or to separation, Doseribe oction token of proposed in Section C.

Performance meeto all requirements. It Is entiroly satisfactory and is characterized neither by defictency nor

A= Adgeavote
szcollence,
P+ Proficient Performance Is more thon satisfactory. Dasired rosults are being produced in a proficiont manner.
$+ Strong Porformance Is characteriiod by exceptional proflelency.
O- Qytetending Performance is se exceptions! In relation to requirements of the work and In comporison to the parformonce of

othors doing similar work as to warrant special recognition.
_— SPECIFIC OUTIES
List up to six of the most important spocifie duties performed during the cating perlod. Insert rating loiter which best describes the

mannor in which employeo performs EACH specific duty. Consider ONLY offectivenass in porformance of that duty. All omployees
with supervisory rospansibilitios MUST ba rated on thelr ability to supervise (indicate number ol employees supervised),

SeRDIE BUTY hort _ _ _ ee SE
Supervises office staff of Mexico Desk in preparing correspondence, keeping
files, sarding, and training new personnel. | 0
t
ShECIPIC DUTY 1.2 en ee rt tena en mee Se pee He Tanving
Dest intelligence officer for tmortant satellite ond FI operations in
Mexico, procesatay projects, hand) Log operattonat correspondence, cor aducting | :
S.

ifateon with-other divisions. -- ee aS
SPECIFIC DULY NG. & ~~ es er | RATING
. . Lurter
Routing cables, digpatches for the entire Desk, supervising distribution |
of work. H 0
‘ . . i
Srectric Wie OUTY No.4 “ ee - — To waar
Personally handling large mumber of clearances, project approvais, cable i
coordinations, and official negotiations on mattera touching all aspects ! 18]
aa Ok the. Dee IEG WOE a an a nee te cere etree nee ee
SPECIFIC DUTT NO. 4 1 RATING
. H LETTER
Preparation of budget, speclal papers, “gurveys, and briefings. ‘
i 6
SPecwiG GUITNOS na - oe rn ee - aie ering ee
7 QFYTES
oe ee OVERALL P ANCE IN CURRENT POSITION
TATIAG
LETTER

Toto tate account everything abcut the amaloyoo which Inflyencot his offectivonste in his current position acch os per
formance 2f apecific duties, productivity, conduct av job, cocperativensas, partinont portoral sraits of habla, ord
particular limitations ce tetents, Bored on yave knowledge cf employos’s overall portotmance during the rotiog pertody: QO
o the letter is tha tating bos comengaating io tha statoment which most oceurataly zaflocts hia fever of pertormance,

g

4

SECRET

Fo i
ioe" 45) eesounte pagvieus Gulrinns.


14-0000

PCOMMENTS OF REVIEWING OFFICIAL

SATE

SECRET

(When Frited tn)

SECTION C NARRATIVE COMMENTS

Indicete significant strengths of wesknosses demonstrated In current position kseping in proper perspective their relationship to

overall peelormance, Stote suggestions made for improvement ol work performance, Give recommendations for training, Comment

on foreign language competence, Hf required for curront position. Amplify of explcin rotings given in Section B to provide best

boats for determining future porsonnel action, Manner of partormance of monogerial or supervisory duties must be described, if
applicable.

This officer is the person chicfly responsiovle for the Mexico Desk's
deserved reputation for excellence and effictency. The complicated and
never-ending tasks of project processing, clearances, tracing, ond coordination
are handled by her with blinding speed and unerring perfection. Procedural
problems are there to be solved, and the solutions come vith amazing rapidity.
Operational problems are worked out thoroughly and conscientiously. No

corners are cut and no principles are compromised.

Never at a loss for an answer, this officer never shrinks fram any
assignment and instinctively wants to take over any vexing problem which is
holding up progress. She is complete mistress of file and record resources
and ansvers all queries within minutes. The most complex budgetary and
planning projects are handled by her with deceptive ease.

These qualities of. rare efficiency and speed are coupled with an even
rarer degree of amiability and cooperativeness. The work which procecds
under her at such a break-neck pace nonetheless goes on in an air of placidity
and good humor. The large office staff is run without a trace of tension,
jealousy, or friction. All of this is traceable to this officer's fine
example and catalytic effect on her colleagues.

Finely-educated, handling the Spanisn language with fluency, ami keeping
up with current events in her area, this officer is a unique asset to

sect GN oCTe™ te CERTIFICATION AND COMMENTS

BY EMPLOYEE

r] CEPTIFY THAT 1 HAVE S SEEN SECTIONS Ee By AND C | COF THIS | REPORT

DATE Dé ree 196 SIGHATUNG OF EMPLOVEE |
c TUAY: Va Dk
y 3 i Chaka ce +
2.
- CEnia. if THtS REPORT WAS NOT BEEN SHOWN TO EMPLOVEE, GIVE EXPLANATION

DATE TOP FICIAL TITLE OF SUPSAVGOR i ak ie “pega ei Eu; OF * BIS
oes

ry, ‘orn Sc sale

Pewee bea beeper oe

26 February 1963 O/H /S/HEXKICO
3 . " BCREVIEWING OFFICIAL

pete ee ee ee ~ f.
TORPIGIAL TITLE OF REVIEGING CERICIAL [rs rong O08 HAN RACHA NE AND SIGNATURE
1
i

2é February 136350 | aAcs/un/3


14-0000

. ., ™ SECRET ™. ;
. hen Filled In)
” EMPLOvERS sr RTAR

eee

FITNESS REPORT CSED
Nin _ norte
SECTIONTAY _ GENERAL :
1. NAME (Laat) (Pisat) 7 oO. a. aX S
BUSTOS-YIELA — Charlotte 12 Jamury 1929 Fonale 12
G. SERVICE CAYIGNATION! 6. OF FICIAL POSITION TITLE y. OF F/OIV/GR OF AStIGNWENT
D Operstions Officer ; . DpP/H/3/D. Ce
TYPE OF OF REPORT

s CAREER STAPF STATUS

XK TSC BC BCE COO
[“[rewome | Joxcomao | Jouwino | “X[amwuan | [nenasiommentauocovee

SPECIAL (Spectly)

VO. GATE REPORT OVE INO.P, /11, REPORTING PERIOD
ax 2? i “Jan 6) - 31 Dac 41
SECTION a EVALUATION OF PERFORMANCE OF SPECIFIC DUTIE .

List up ta six of the mast impostont specific dutlos performed during the rating period. Insert rating number which bost describes the |
mennor in which employes performs EACH specific Bm uty. Consider ONLY eHectiveness In performance ef that duty. All empleyeet
with avporvisory responsibilities MUST be rated on thair ability to supervied (indicate number of employees supervised),

2-Borely adoquato {3 - Acceptable | 4- Competent [s : Excellent [6 «+ Superior [7- Outstanding
i NO.

opecivic ote NO.4 Assist tho Chief of thejrarme
renewals anJ other correspondence and desk in administration of office to |

action on 12 su; cork tne projeats for agsure the of) functioning of the
dont ged Inehiice Lietrbbetiin of work

SPECIFIC DUTY NO. ESiand Je “niseollancows adrfi HAE AYEKNOXK routine uD pouches and |RavINo

ani suprort ratters (requests for tech cables, supervision of clerienl staf?
eguin, studies, trainins guides, ete) | 7

é

of he

for Mexico and lonterrey _

SPECIFIC OUTY NO. * 2Suupe rvice maintenance off RATING SPECIFIC DUTY NO. 8 RATING

records at the desk and represent Desk

ag Reeerds Officer in discussions vith! 6

oT on Vis end Ciel? aoopda prohtens

SECTIONC “EVALUATION, (OF OVERALL PERFORMANCE iy “ETN CURRENT 1 POST (THON,

Take into account everything ubout the employso which influances hie elfactivaness In hie cuccant position - gorioemanca oF asecthie
» Coopeentiveness, pertinent personal trade at holuts, puriculan bieattations of talanta. Bases oa

duties, productivity, conduct on job
your snowledse of employee's overatl parformanea during the ruting period, place tha raring number In the box corrosponding ta the

atotoment which most aceyrately reflects nls level of performance,

1 + Performance in many impertant reepecis Vaile to-mest requicemonts,
2 ~ Performance meets most sequiremants but is deficiant In one of more nportonr teapacts,
3 - Performance cloarly neote basic requirements,

dy Performonca clearly exceeds basic requirements,

3 ~ Performance in every important respec? is superior,
$ - Paclormonce in evary raspoct Is oulstanding,

“DESCRIPTION GF THE EMPLOYEE __
the dagres jo vhi
[3 = Normal degree $+ Abave average deqeas Is: Outstanding dogree

teats aebeetsnene anaenel
» NCT { NOT RATING

APPLIS | oD: =p
CAaLE [SERVED 112 Tviwa: 3 i
ae ane rok —
on}

~ Tuanacremstied

GETS THINGS GONE
eenenpeahants pee — wenn _

CAM MAKE GECISIS>

WRSE SOR

SECRET to

Seb ott TION UF +E? aay REYVT

rae
asa 45 OBSGLT IE PREWIOUS BOITIOMA,

SERN -epeyry ete ore ertreree ne rr twiiceeee——

14-0000

SECRET

pWhon Felted Int

SECTION E _ NARRATIVE OESCRIPTION OF MANNER t OF JOB | PERFORMANCE _
St gths ond weahn: domanstiated In current position, Indicate vagesiions « mv ployee foo ictptterment of his
work. Give recommendations for his training. Describe, if uppropriare, his potential fas development ond for assuming greater res
sponsibitities, Amolity of exploin, If appropriate, ratings given in SECTIONS B, C, and OD to provide tho beet basis for determining

ulure personnel actions, . ; fog I2 il ue fit 62

This outstanding en:]. joyeo Weis reinteined the Alich ebacdard of pers
formance set forth in the report of thic sunerviror bhi yoni os here
possible, she hes exceeded her earlier rerformance record. Uaring the

: ast year this office acyulred cong ideradle new versonnel, witen sudfect
trained in a hichly canable manner to guarantee the neo the fonetioning
of the office. The wiiersiened horce this employee will cor.*inue .to

* serve this orzanization indefinitely notwithatanding her rarriage

during the past year.

SECTION F CERTIFICATION AND COMMENTS
L BY EMPLOYEE _ ;

TF Teortify thot} i have seen Sections A, A, 8, ©, D and E of this his Report,

BONATU UF oF aurvored < Lf.
mary wir ‘a aed q
me Tenwary LOGK Chest Latdee- 2 Lh tates -L Lbele,
i. : bY SUPER
MONTIIS RMPLOYER H4% UREN IF HID REPORT HAS NOT APEN SHOWN TC EMPLOVEG, GIVER ZAPLAS FGF
_ _ UNDE MY SUPFRYISION
ah -

MY TUPEN VISION L853 THAN 02 Gard

UNDER MY SUPENVIBION LESS THAN Of GAYS cee eae eayy

Orde (Spacityy:

2 ob ntretaentanetin os ~~ wee
DATE OFFICIAL TITLE oF , SUPER vIsGn . TYPED OR PRINTED §
23 Jgpnary 1962 Chie? af Ues

Je

yi OULD NAVE GIVEN THIS EMPLOYEE ABOUT THE Save e

jt can NOT Juven 7 THESE EVALUATIONS. 7 we NOT SUPPICIENT EL Y FAMILIAR with THE RMPLOVEE® J PERV CAWANCE,

"COMMENTS OF REVIEWING OFFICIAL

Ra my ont POMATUAR

He Lawon

. wear REViEoING Orrician
val, 4 Coho tie
SECRET


14-0000

aN SECRET ts

PWhen Fed mr)

EMPLOTER SERIAL NUMRER

. | FITNESS REPORT
“OY

ECTION A i GENERAL

t. wAME (aot) < rely (tiddta) j2. CATE OF BIRTH
Zehrung Charlotte : 2 Jane 1929
8. SRAVICK DESIGNATION] 6. OFFICIAL POBIFION TITLE
rn —_____Ops Offi

CAREER STAPF STATUS

[[esworee | Joxcumes | [ounies

J 22D = Dec a
SECTION B EVALUATION OF PERFORMANCE OF SPECIFIC DUTIE:

List up ta ala of the most importont spocifle duties Pattoreed during the rating porlod ort rating number which best doacribes the
wonnar tn which omployee performs EACH specific d uty. Consider ONLY effectiveness in peclormance of that duty, All soplorees

with supervisory rosponsibilitios MUST be rated on their obility to supervise (indicate number of employece supervised).

1 Unsatisfactory 2. Boraly adoc adoquete 3+ Acceptable (4. Competent {5 - Excetlant [S- Superior | 2~ Outstonding |

SPECIFIC OUTY NO. Responsible | for co and |< [tesk 4 DUTY NO. Aguigt the Chiof of the [Aatino

renewals and other correspondence and Mesk in administration of offica to aspure
action or 12 supporttypo projects for; 7 | tho smooth functioning of the deske |
Mexico City and Monterrey _lIncludes distribution of work, routin

SPECIFIC DUTY NO. Randig miscellaneous adn BATINS [Steerer erties of pouches and cables, [F47jNe
and ‘support matters (requests for tech | Supervision of clerical staff of h. .
equip, studias, training guides, etc)
for Mexico and Monterre:
seECiPiC DUTY NO. aSupervisa maintenance of! RATING jsPecimic purr Na, &
records at tha desk and represent Desk; _
as Records Officer in discuasiong with! 6 :
RTD on Hog and field rocords problams!
JON ~___EVALUATION OF OVERALL PERFORMANCE EIN ‘CURRENT PC ‘POSITION =
fac Ina account everything about tha omployaa which inflvenras hia ettectivensss in bis cuseent pavition ~ performances specific
dutees, productivity, conduct on job, covperativengan, pertinent persorct traits of hoblts, particular limitotions of talents. ihused 61

your knowledga af einployeo’s averall perfyrmaaca during the euting paried, ploce tha tating numbor in the box correspanding ta the
9 La ; OG J

en statement which most occurately reflocts hia loyal af parloresance.
1s PRarfermance in mony important refpects “faila 1a inset toquirements,. waringl

2 - Pottormance moots most foquiremeais but ja deficles? fa ane ar moro Lnpertaat respecte,
2. Porldrmonce clearly moots boate roquiteweata,
4. Performance cloarly oxcoods bosic raquiramenta,
5+ Performance fa avery bnporant raspge? cs superior,
6 - Bortormance in avery respact 3 oytstundiag,

“is ies ere “DESCRIPTION 01 OF TS

413 300 ier Os

. AciTavEs IMOCTH OPERATION OF Mis onrick

safes Swrecrively

roNserces
TaisKD cuwaaar

Dia IND, MAINT AS

and BiEPORING oF ey

Fe SECRET da

asa 45 casociry ane yiaes eorticn,


14-0000

SECRET OFFICE OF PERSONNES

(When Filled In.

SECTION NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCE _

Stress strengths and weakoovses damonatrotad in current perition, Indic ote 90y94 stions mode t f fires hep PAG of hie
work. Give recommondations for hie wining, Oereciby, ib eppropriste, his potential for develo, tidad tab o i for ro.
eponsibdilitios. Amplify o# oxplain, il appraprlote, ratings given in SECTIONS B, C, and D te provide the boat basis lor datormining

future personnel! actions.

MAIL ROOM

This is a truly outstanding employee with capabilities far beyond those
required for her present position. She hag an unusually keen mind, makes
decisions that are correct without hesitation and carries out all actions
promptly and efficiently. She is the supervisor of the office staff, who
respect and admire her ability. In addition to her skill, she 1s possessed
of a most pleasing disposition which inzratiates her with the other members
of the staff. The years of experience gino has had at the varioug jobs to be
done at a country desk make her invaluable as a trainer and supervisor for
new personnel. Her knowledge of Spanish haa also been especially helpful at
the Mexican fesk. This supervisor would be most pleased to have her serve
with him on any future assignnente

SECTION F CERTIFICATION ANO COMMENTS .
1. ve pee oe BY EMPLOYEE ep een pn ne

[ conrify thot Thave Seon Sections A, B,C, O and E of this Report
OATE [tonarunt. oF THPLOVER ~~,

we cv
Ui tecember eh) | ee he A Lett pe ces tee eee
ro . BY SUPERYISOS, 7 7 : ~
WAR NOT BE Oo Eel ovedt, Glve EXPLANATION

HONTHS EMPLOYEE W48 SEEN Tig THIN REPONT MAS NOT BEEN SHOON TO
UNDER Att SUPERVISION

| | eeeeneeee = __— an es a ee

17 REPORT 19 HOF ONG MAOK AT THiS
pete rue on

or cen eect eer nnn UR Sere neti ee maces mane fa enim ent met
OFFICIAL TITLAR OF DUPER VISOR TIPPED GA PRINT ZO AANN ae siowpaiee
: X ‘

jdohn G. Heyy TY ww
777) nna ~ fren pene nen annarernnerre mmr

lemcovee UNOR SUPMAVISION LES PHAM 90 Gand AK ONT MADE OY LAYT 90 DAYS

verti ee

gua}

Sosk Chis

LM wave GtvEeN THES EMAL

MPLOTER A LOMER @ VALUATION,
an pee eee ene ee en eee ee ante sma emer
LUE TLE eh GAY PP PMOL TERS PRP Geek By

aan. LEM OUEO A
i RANNOT JUD
COMMINTS OF REVIE DING OFFICIAL

Torvician TIER OP ASWIB INS MOP as PP PPE oR eaNT ED NANG ANG BIDNK TIRE .

: a Is at HH 3 - a i f a Hy sad (nck.
- 4 SECRET

14-0000

— SECRET +/f - gins |

\ ce (When Filled In)
. . P¥PLOTEG SERIAL NUMAER
FITNESS REPORT :
ECTION A _. GENERAL . —_ _
t. MAME jheet) (Fiteatz (Middle? 4, DATE OF B:QTN 3. SEK 4. ORAOG

: -

' ZEGRUNO, Charlotte -. Jona -Female___i_GS.

6. SERVICE pesronarhy OF FiciAL POSITION TITLE 7. OF F/DIV/OR OF ASS MENT

: D 2 0._(2L Dpe/ W/L fart /D

CaRGER Starr status -] tree ¢ or Ne PO:
[ [wor sutarove wEMORR OnRENnad HUTA REASSIGHMENT/BUPEAVIAOR

Lh REPORTING PERIOD os SPECIAL (Specify)
1 October 1959 a May §9 30 Sep §

SECTION B EVALUATION OF PERFORMANCE OF SPECIFIC DUTIES

rlormed during the rating period, Insert rating number which best describes the
Consider ONLY clfectiveness in performance of thot duty, All omployoos

List us to six of the most importont apecific duties pe
{imitcate mander of employeses eupervi aed).

manner in which employee porlorms EACH spacific duty.
with supervisory responsibdilitios MUST be roted on thois ability to supervi

1+ Unsatisfactory

SPECIFIC CUTY NOt
08} 0:
eT ond

SPaciPic OutY NO. f

‘ fmpndles Der
vit. Statla.

Fehy

mer renee

SPECIFIC OUTY NOS
susavisea «inten
ami profeet Stles

SECTION C EVALUATION OF OVERALL PERFORMANCE IN CURRENT Posh

Taka into cecaunt everything ohout tho employes which Influences hia effectivencat in hes Current podetiad - portatmancea of apecitic
dutiot, productivity, conduct on job, coupsraneansss, pertinent personal brains oc hetite, particular fimtations os tatanis, Based on
your knuwiaiige st sinplaysa’e ovurall purtermorcea during the ratiog ponod, place the caniag nwisber Jn the bau sorrsspunding ta the

atatoment which t geeyeatoly catlocts hoot vel vl perica mane

f 1
1+ Poclormance In mony impartant respects fails to meat requircoonts, “won|
2+ Pordermance moots rust raquizements bur ia dolicsent in one at aces iinpartent eetpects, 4. .
3. Pethsemunes elaarly ncota hasic sequiraments, 1 4/4, |
gta

§ . Porlormsaca closely oaceals buaie requirements.
S + Partorwonce in every important ronpect is auperiar, . |
8 s Parformance la every tossact ta 2 eetatanding.

akon } 5 pals”

wee +14 3. apa

AN Mand Be crarans

“COrE HS JOO WITHOUT ary SUDPOaT

ates ean0t oreaarid ar

Been feed
i i . ,

weiegs weracrivacd

RET De BE en eee
yer gine
#. ca a a an SER ig EE

sewed Cagecthrt
nee = Ee ROCF Sera AN NT nm er mo aera

ENS aT de ape OWN
ee x ene REE RMR = OE ofS NER NIN NOE AAS ERA ENE 8

we 4S eseng. para. c agttans, SECNET set


14-0000

StcrZ} ate

Abner Fd hey
DESCRIPTION OF waeinE a OF JOB PERFORMA, 4S tune
dete employes tor fae Paement ol

Sirens ttroagths and woaknas pad Apenmmatestad 19 eusren? posite,
moth. Give recommendations fer bie traleing, Uniiabe, of opprsor vie. slopmant ged fn sisuming g
Amplity cx veptain, 4 spprapeiiuin, rulings grea mm SLTTIONS B, C, andUf fo wine Lest baste for doternining

pow ee

SECTION E- MAS HATIVE

ule sugyestion
petential for

jeoneibilines. 1
vivre parsonnel actions. ¢ &y Duss
4 ¢ Hf 59
. . 44
, " Rooy
Please sso previous fitness report, Tais employeo was rated fuur months

ago. Thers is no change in the raticg; she has continued to give un
outstanding porformanca,

CERTIFICATION 20:9 COMMENTS
BY EuPLcr se

~ — t ently thot [have sean Sochans

“soa tuRe Gh,

SECTION F

saree me tena mt 9D

we OO PMPL OVER, Olde BFP Raa IS

we fer) nee. wel

' HAD ‘No? get

MONTHS EMPLOYER 48> Brey
UNDG Mr SUPRA ISION

2b months 3

fF ee hone ie noe ae

lauyLores us

fo rees (Spee itr

wee bak

&

“ i i “
GPa TTL Mess bere } / vom 2, irety

‘fam eae ®

OF “Yubet vreeae & yen oer ae

BOhe Gta OF REvWwING Gras, &s

perersr terri re 7 Pee on om: den Bas Awe 24 Serene

Soi Oo Bg

ape AGI : .


14-0000

j
i

SECRET

. tee ‘ oY fWhen Filled jn)

7 : ~
, FITNESS REPORT
SECTIONAL GENERAL
tt, AME (Laat) (Pivet) (Middle) 2. VATE OF BIRTH 3. 3En
_ ZEMRUNG, Chirlotte de 12 Jan 1929 F [2
~ Pe sdavice Desianarion| 6. orfictan POBITION TITLE 7. OFF/DIV/BR OP ASSIGNMENT
DI 1.0. (FT) : DDP/WH/TIT/Mexico/DC
A TYPE OF REPORT

a. , CAREER STAM) STATUS
| [wor actome [x [ueunen | Jusraanso

10, DATE REPORT OUE IN O.F, preg PORTING PeRIvO 0 SPECIAL (Spectr
28 Auzust 1958 28-Augunt 1957- Bl Ma

SECTION 8 EVALUATION Of PERFORMANCE OF SPECIFIC DUTIES
List up fo six of the most important specific dution partormed during the rating period. Insort rating number which best describes the
vty. Consider ONLY effectiveness in performonce of that duty. All employeve

mannor ta which employee performs CASH specific
with supervisory responsibilities MUST be rated on their ability to supervise (indicate number of omploywes supervised),

1 - Unsatisfactory 2+ Borely ‘odequate “T3. Acceptoble [4 - Competent [5 - Excoltent Is « Superior

SPECIFIC OUTY NO. Ft RATING | SPECIFIC DUTT NO. 4 .

kesponsible Cave Cfficer for several * lConsultg end coordinates with various

fT und CE/CI Frojects - 5/6 |Has components regarding Station's

~ Frojects snd ‘perationa
RATING [SPECIFIC DUTY HO. 8

SPECIFIC DUTY NO,2 . . NO
Handles larje volume of correspondence Prepares, reviews and coordinates
nemoranda

with Station 4n eupport of Overationa | 6/7

7 - Outatonding

SPeciric OUTY NO. 3

Gupervises maintenance of: deak records
snd project files 6/7
SECTION C EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITION .

RATING [SPRCIFIC DUTT NO, 6 RAIN®

T2k9 into uccaunt avorything obaut the oingloyoe which iniluances his affactiyenses in his currant putition - pevforianes of specifle
4utlen, peaduetivity, conduc’ on oh, couperativensits, portinent porsonal traits as hobits, patreulor lunitanons of tatenta, Gased on
your knowletca of amployee’s ovarntl perfcrmance duting the rating poriod, place thy roting number in the box correszonding ta the
aiatement which moat aceurutels cablects hhe lewvat of pectormanca,

1 - Porformancea In many Impnrtant roapactstails to mont requiramants, Ipatina
2 + Parlonoance mots mast requlraments Sut is deftclont in one os more finpestant rotpecta, ; ue

3+ Perfarmoncae cleyrty moute basic raquizoments,

4. Parfermance claorly oneends baste requirninants,
3 - Porlormance in ovary }mpartont respeet la superior,
6- Performance in evary saspect la avtatonding,

SECTIOND ___DESCRIPTION OF THE EMPLOYEE

fn the satl

+ Outstanding dagres
AATi—G

we ee renee

+ Limited dogina “| J > Neemal deqroe A- Above Byarage dayrae i
ae oe ne Mtn be nnn ~ 7

1 - Locst possible degrea

. NOT i NOT
+ oe8-

CHARACTERISTICS

+ WRF HEED ARISES

S7HONG SUPEURT

q 5
a aa eae ae Ba ween
¥

} ; ; [A
SF RECORDS pee pose oo
ae eo ee os Be ee ee ee oe
é. tty de ee re Fa iz 7 t
iSpectte _ ___ eee

SHE SECTION °F? ON REVERSE SINE

UISCePLINE IM OAIGINa Tid, ALN Te

oe 45 onsouers pag sous AO tOn8, SECRET fo

14-0000

SECRET
Wten Filled Ind
SECTION. € NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCE = p 4
trengtha ond woakneeses demonstrated in current position. Indicate suggestions mods to omployee AS SS PbRinoar of his

. e recommendations for his training, Dastribe, of appropriate, his potential for development and for assuming greater re-
aponalbilities. Amplify or expiain, if appropriate, ratings given in SECTIONS B, C, and O to rey the best bosis for determining

future pertenee! actions. Jt ai 2 5) PH 59

Tis exployee is intelligent, loyal and dedicated to duty. She has an
outstandins ability in getting her job asgignnents ereiematall Tie thrid and
with a minimum of time and support. She readily cccepts respoidibi » jaa
highly effieient worker who thinks clesrly and logically. Her knowledge of
Headquarters and Field procedures plus hen ability to organize her work greatly
facilitstes the smooth functioning of the Mexican Desk. She has demonstrated a’
superior comprehension of the numerous and varied projects of the Mexico City
Station ‘hich has contributed to the overall Headquarters support of the Station's
operations, Because of her sound unJerstanding of operations and her outstanding
capacity for work, Miss Zehrung has an «xcellent potentiel for assuming greater
responsibilities. Additional training is dependent upon her future assignments.

CERTIFICATION AND COMMENTS
BY EMPLOYEE | ene
B.C, D and E of this Report

"bee i | cectity that 1 have scen Sections A,

Se taeeeeeaientameenein SIGHATORE UF Drea
yi oy | ? oe
wt. gexe * Se eas eee aS lume
acre dow ET
y BY SUPERVISOR hae” ee 0 na nen

UNOET MY SUPERVISION

22 7 Ronths

ne A ee eee eee te ener en pete e
MONTHS EMPLOYER 18% QUEEN te THIS J REPORT. res NOY DREN SHOWN, ‘yo © CMPLOYER, Give EAPLANATION

Vw REPOAT 1s Not Ban ING iG MADE at The Ne, dive. REASON.

—Tipoves OER MF AUMEAVISION LESS THAN 00 DAYS
Jempcoved onsen we sunenvision Cicss Twan oa nave UT

jotnar CSstecin:

DATE

[rewont MAGE WITHIN LAST po GAYS

“Trreeo ot PREYTED NAME AND S1aN TURE
Yate Sip
John” os Crady

BY REVIEWING OFFICIAL i

a t WOULD HAVE DIVES THIS Es Eur LOVER ABOUT Pic SAME EvaLuaTioN, .

lorFICIat TITLE OF SUPER YISOR

13. Sune 1959

HOLS HAVE GIVEN Tras g EMPLOVES A A RIGHER EVALUATION,

\

TeeNnoT dl 1vOcT Teese EVALUATIONS. 1AM NOT SUFFICIENTLY FAMILIAR WITH ne “EMPLOYEE'S PERV ORMANCE,

“CouMeNTS | OF REVIESING OFFICIAL

TOPFICIAL TLE oF PUVIee: nes “SPriian TrPER On PAINT tO % wane rnd SlgnaTUuRE
YN ee ay: me
eren ~

wt
NS

O/H /IIT Lute? c

3.

7 ~ SECRET


14-0000

“SECRET .

. i we _ 8 (then Filled ta} 4
FITNESS REPORT (Part 1) PERFORMANCE
INSTRUCTIONS ee

zg this ecpart.

Fw THE ADMINISTRATIVE OFFICER Consult current anatructions lor complet

POR THE SUPERVISOR: This report is deeigued to help you caprese your evaluation of your subordinate and te tronemtt
thss evaluetion to your supervisor end senior officials. Ocyanisation poticy requires that you inform the subo ries
nate where he etands sith you, Completion of the report can help you prepare for a discussion with him of bis
atrengths and knesses. Et ds also argeniaation policy that you show Part lof thie report to the eaployee encrpt
under comlitions apecifacd in Regulation 20-370. It be recommended that you read the entire form before completin
eny westion. Uf thia ais the initiss ervort on the employee, bt aust be completed and forwnrded ta the Office o

Pereannnel no Sater than 30 daya after the Inte indicated in item 8 of Section A below,

SECTION A. GENERAL .
t. NAME (Laat) (First) ¢Wsddle) + DATE OF BIRTH
ZEHRUNG, Charlotte L. 12 Jan 1929
> OFF ICE/ DIVISION’ BR 6. OFFICIAL POST
i Dor /wa/t1/D0 77, Reports Officer
ve PERIOD COVIREO NY HIS REPORT (Inclusive dates)

‘ B. CATE LEG

23 August 1956" | - 2¢ August 1957

Trek OF REPORT
(Check one) CARB coutatecMP lovee

SECTION B. ; CERTIFICATION _ _
1. £OR THE RATER: THiS REPORT was £ WAS NOT BLEN SHOWN TO THE TNOTWIOUAL Rateo. VF NOT SHOWN. EXPLAIN WHY
hor — .
t . aes Sank See 7 nD
‘ &. CHECK (X%) APPROPRIATE STATEMENTS:

THED HEPOUT BEOLECTS MY Gey OPintGmd OF IMIS ERDI-

yioual. .

THES @EPONE REFLECTS THE COMBINED DPI MIGHS GF MYDELE ‘
KX jeno pecvrous surcnvisoas, P GSALU ATE wtb soo Pp

f WAVE DISCUSSED SETH THES EMPL OSES
AUG WEAMHASSES 30 THAT nl wudOS ewfat we Dieuus,

WJD SIGNATURE OF SUPERY "| ty, SUPLHVIGOR'S OFFICIAL TITLE

en VA A | [‘oAm/trtextco

WANCE OF NTC" wt Toh THE SUPFRYYSON, OR ANY OTHER IA>
Pnats: ee d

VF inmbivbOuay bs saree “tte Clo of 0. a waauing Ante

Den GAG Gant To wim AA Coy ATTACHED Toy THES REPORT,

Camnot CORTE RS TwaT (wh BATCD ImoOtvibuar BNOee HOR
wrommamce uecausd (Specify):

wid STOUNGTHS

TE Ge TYPED OP FRIWIED f Pye

# tS

20 January 1958 {| John B. Brady os

i PECOKD Pye Satie FANT IAL QUEEF
FORA bud, Wels woke eh Aw SG A ek Tee of

pe on qe

SEED Om ATPACHED SmHedt

the sbove section,

errr eres Yh Tepe Shiai nhs Galaga ae ara OFFIC aL Teta ve HUW ERIN OrrECTAL
21 January 1958 Orrist*@, Ne Dahlgren CASH/TT
pe bige C. NOS PERFORKANCE EVALUATION eevas sneaneom

TinG ON Gtytar PERRORU ANE

[a *  Consadee Only the productivity
fiat cutues during the isting pescod, Coapare
eititaty. Factors other than productivity mali be takes sito account

aod effectivenesa with which the individual beyvoy cated haw nertorme t
a GALY wath others duing stcaifiar work nt a aimatag tevel of cospone
later in section D.

yoo Po. SOLS NOT PearoRe CUTEES AUFGUATELY. HE ISTINCOMPETENT.
j Ziv WARELY ABLOUVATE pe Pome ek ALL Gee Er AS Me SPEGHEIG astMANCE ON TRAINING, ME OF tN Farls fo
i CARBY OUT Reve oe SIBLE DEY
I 3s PERFORS VOLT OF WIS OTs at TAGE. QCCALEDWALKY HEVEALS S0UE ANEA OF aEARNESS.
eee? 45 PERFORMS SUTICS IN A KGMPLIGNT. EFFECTIVE WANNER,

os Boe A FONE PERFORM INC EL. CIO TES GUE WANT SF MES DESPONSEGILITIES EacePTiseacay actl.

UMGEA Gor PECANS WES DUTOES 1 Sor An GUPSTANOT AG “HANNO HAT UE G5 EGVACLEG G1 Pea OTHER FER DINS KADEN TO

Tut AUPERWSSOR,

COREUENTS. .

1 etn te Rr

os TEP RALHS PORE Ye er etal es nm ey . — —_
sae bo. race no. YS (Part TL) Tse as oe oe SECRET Performance ao

1 aor 4
3 ART casa te


14-0000

a

ae anem
wie
father Fatiet In

He SPECTRE BUTTERS

an wee 1 on MECH fie

PIETCTIONS ‘
a, State in the spaces befos up ta sia of the meee epactant SEPCTFIC duties pee Ahoy apes tne thie rating period,
Plaee the meat seportant Breast. Mb aet inebade miuae or unimportant daties, '

4 ONLY slfectivencss tn performance of

RATINGS CN PLOEONWA

be Rate perinruanve on each speed lic duty conesderre thine epeci fac duty.
c. For auperviaora, abblety ta supervise will nheays be pated aaa wreedey Oy y(ie wot cate as supervisusa those
whe eupervise a seceetary only). ¥ 2
the indsvidual being sated earth othe Os Pay ips the same duty at a

J. Compare in your mind, when possible,
aimetor Jovel of reeponsibilitys 8,
e them on different

fob cathe may he perforaing different dution, fav,

ce, Teo individuals with the tame
duties. 1 D7

fo fe specific. Paamplee of the kind of duttes that might he rated are 4 Rp
ORAL BRIEFING . HAS AND USES AREA KNOWL BOGE OMoucrs INTERROGATIONS
GIVING LECTURES DEVELOPS NEW PROGRAMS _ PRAPARES SUMMARIES
CONDUCTING SEBINARS ANALYZES ENDUSTRIAL REPORTS THANSLATES GERWAW
WRITING TECHNICAL RAPORTS WANAGES FILES DERALEFING SOURCES
CONDUCTING BXTERNAL LiAISON OFERATFS RADIO KEEPS pOOKS
TYPING 1 COORDINATES WITH OTHER OFFICES DRIVES TRUCK
TAKING DICTATION WRITES REGULATIONS MAINTAINS ALM CONDS TIONING
SUPERVISING PREPARES CORRESIONDENCE BVALUATES SIGYIPICANCE OF DATA

widere it advisable, @.€+. combined key

g. For some jobs, duties may be broken down pven further if supervisor con
and phone operation, in the case of, radio operator.

Ve TNCOMPLICHT 1s fee PAPORWANCE OF tais DUTY ~ eo: PERFORMS tis bUTY IN AN OUTSTANDING MANNER
2. BAWELY ADFOUATE IN THF MERFORMANCE OF THIS + FOUND IN VERY FEM INDIVIDUALS HOLDING SIMI+
DESCRIPTIVE DUTY LAR JORS
RATING 2+ PenranMs THis DUTY ACCEPTAMY 7+ EXCELS ANYONE | KNOW CM THE PERFORMANCE OF
NUMBLRA 4s PLAFOAMS THIS DUTY 1h A COUPETENT MANNER thts Outy
8. PERFORMS THIS CuTY IN SCH, A FINK MANNER
WAT OE £3 A DISTINGT ASSET ON HIS JOD
Vrecttte CUTE MO. wt tame mmm eT aa rine fee ner ree So re
Supervises mali:tenance of desk recordd wenn Extracts pertinent information from = jms
and project files, 7 reports gnd atgtistica for thes prera- | 6
ca en en ne nee nee ration. of studies |. WW. --- bea
saucers gouty NO. 2 RATING! Serciere Gate wt. 3 RATING
Reviews and coordinates memoranda wut Prepares cables and dispatches for the) ™''"
- nO (2 ee
RATING[sFE CIFIC Outr Wo. RATONG
NUMALR

aergiebe oyte ma.

a
Procenses for dissemination reporta =| """'"Isunervises maintenance of country deze
from field stations 5

oF Jon PED

ANRATHVE uf Glare ed

Thich nifect development on prearnt sob.
Ticient worker who in accomplishing hor job assignments has

performed in a very outstanding manner. Sho has the ability to think clearly ard

logically and at 211 tines exercises extrame good judgment. Her knowledge of Has and
field procedures constitutes a proat asaet and she has the facility for pleking up
douse ends and keeping an office snootily running. Sha is willing to umertaze any
assignment that facilitates re tiing the Job done and is entirely capuble of seeing

that the jJeb de properly done. Her contribution to the job reflects conscientiousness,
joyalty and devotion ta duty far above the average.

Stresa steesgtha aad knessea, particularly thoae

This employee is a highly ef

i A EE I
“SECTION SUITABILATY FOR CURRENT JOD 1X ORGANIZATION

foke untae account heee cverytl
vhoractecratics oF AehtEs,
ar avek of about Uae same bevet.

Seo he aE oCPARATED

adutO NOt «kes ACCEPTEO WIM TF FAR ANON BEAT L Auda nga

Frye sDELOR AVERAGE GYT ETH NO BEASNESSES SUP PICU BLESTAR GINS FO AARe

peadactevity, conduct in the job,

you few. sbout the individu
fits an esti your tear. Com

apersal defects ar talents... aad dow he

pertineng personal
perce bim sith cthera dotng 4atk
Yoo BUTTERY unser PAGER + ht

_ “Yon OF GOuAtrUL G,ITAgtT?

Ve A BARELY ArCortanre Furl

RANT WES SEPAW ATION

| 4 ge OF EME TAME TUITAGELGDY AS MOST PROPLE boema Ty THE GNGANTZATION
TITeG OD A PNG Furrur tt MAS soe BOTS TRAGING STEMS TUS .
nuesta 8 7 MEUNUSHAL LE STRONG Pinion thy Thats TF Toh MESURE MENTE GE THE SRUANELATION

- PLR ELLLLED 4¢ OLY A ft ee Sur feorea Te FIG sume Im TF DUGAN FATION

PR OPGSTT EON PS THE GROAN TEAETON®

1S THES eweGeVeOEAL BETIEA SUFTED FOR etn
ENPLATS FULLY :

pee
so o SECRET | .


14-0000

SECRET a
"a fthen Fidled ot .

: FITNESS REPORT (Parl) POTENTIAL
TRSTRUCTIONS _

Consult curtent Tnatructions foe coopteting this report.
POR THY SUPERVISOR: This report tan priviléged communication to your superviser, and to appropriate career manage
ment and personnel officials concerning the poteatial of the employee being rated. It de NOT to be shown to the
tated eoployee, Tt be recommended that you read the entire report before completing any question, This ceport is
Tf lesa than aydays,

te be completed only after the employee bas been under your supecviaion FOR AT LEAST 90 DAYS,
hold nud complete after the oadaye has elepaed, If thie ie the INITEAL REZUET on the employee, however, at MST be

completed and forwarded to the OF no latce than J0days after the due date imticated in item &@ of Section "f= below,

GENERAL

SECTION E. _ eet
1, NaMe cleat) (Firat) (Middle) 2. DATE OF BARTeH a. 8En

Charlotte __

CU/ONVIBION/ BRANCH or ADSI GNMENY

* pop fat /tt /D

GRADE 6.

POR THE AUMINESTRATIVE OFFICER:

SEAVICE OLSIGNATION

oracens (Spocilp)

TvPt OF REPORT
(Check one)

im,

CERTIFICATION ee nen

SECTION F.
1. For of aa AATCR, V CERTIFY THAT THtt ACFORT RUPRESENTS MY HEAT JUOGEMENE OF THE PNOLYEDUAL BRING LRATEO
“BUrRAVIS0R® os OreiciAL TeTLe

TS We ko On PRINTED ar AND STGHATQAU OF SUPERVISOR IC.

aL THES HATA o.
20 January 1958 | John _B, Brady CAMH/TII/Mext co_
RENCE OF OP INTON tN ATTACKED MEMO.

?. YOR tut agyiwing oF 11 WAVE REVUIMY

a THIS DATE 4. TYPED Of PIV a & fi Dart iGiAU TVTUe OF REVIEWING OFFICIAL
OnriciaL ‘

121 January 1958 Lahigran CANN/TII

SECTION Ge WeESTIMATE OF POT EN a se ne we ene ne arene
t. POTENTIAL TO AgguMe carareR TACSPONSEGILETIES ee, _ nen ete eas onenve.
DIRECTIONS: “Consldering | othare of his grate and type of asabgament, rate the employre's potential to RASIERe areater
-reaponsibitities., Think in tena of the kind of seaponsstility encountered at the varivus levels in his kind of

work,

+ ALREADY ADOVE Tith GAVEL AT WHICH SATIGFACTORY PERF ORMENTE CAN AE CXREC TED
THAN HEACHEO Geb FESME SE bv ht SE mC PAT SPA trdy PERFORMANCE CAH me EXPROTED .
| MMCINA RONALD AA not woe MONE TIME OEPORE Wo CAN AE TRAINED TO AN Sums GHEAITD WEGPONS HOLE TIES

1
2
4
6 40+ BEAGY FOR TRAIGING TN ASSUMING CREATIR RCSPONTICELE TEED
5
a
?

o WELL PRODANLY ADFUET QUICKLY TE 4eRF RESPONSI OLA GUTTER WETHBU ET CUR THE TRADING

ORUHEADY ASIEN ING MOYE REOPONTIDEL LILES DAM EASE EGG AT reps PREG ENT LEVEL
+ OAM PSCEPTICHUAL PER IOM BHO 15 ONE OF Tk Few wee SO OR CONS EGEAED FOR PARTLY ASSUMPTION OF StduER
REVEL HE GPOMS IDE U ERS

PIRECTIONS Anawer Ubhia queagtions Hae chia persou phility to be o Vupervisor? vet } you
indicate helow your opanien or guess of the level of supervitsry shility thia purson will reach AFT

enawer da VF
Indicate your opinion by plachag fhe aurber of the descriptive toting below which comet closest

SULTARLE TRAINENG,
to expressing your optaton in the appropriate column, Pf your rating oa based oa obwerviny him aupervise, Bote your
Vi Ueted oo opinion of his putentaat, acte the eating sa the “potratial” cotuny.

feating ta the “setual® cotumn,
SUPLIVISORY FOTFNDTAL tN THES SETUATION
SUPERVISC3 IN (tS Kind GF RE DIATION
tars Nts OF GIETUAPION

you

OJ > HAVE RO OPINION ON HIS

acne tiv
oc ive Poe WMUSEVE tadtviOuUss ROULD VE A Wan

‘
eae 2+ BEE TEVE INGEVIDUAL MOULD HE AN AVERAGE SUPERVISOR IN
Se BEL FE VE GNCETED GAR WOULG TE A STRONG SUPLOVISOR IN THid St TATION
AG THAL POTRRTVAL DESCRIPTIVE SETUATION
WUabur “oan. Tet” osate 108 y peenvgeaphors terhnsciana of profestiunal sper

A GADUF CGI, Tree B83tc 498 Cteuck fravors,
rida) entha Cuetact enim

é Meg ore rh SubSsotNA rea bs FaCduenT Cheese Pine

eialiite af wartaus

a ns CUDEEENEE RT LTTE CTS Renee! ~

tua waded 32¢@ (Second fine sepervivars)

A GPOUF OF SHOE AVIAONS end LrKteE

A SAG, WHO war IN SAY ROT SE SURE AMI SOO a, SIEM US RESPONSIBLE FOR WHTOH PLANS. DAGART TATION

aug Paytee CEavcutare dove?)

venf BOL

TORPSEP AETH TMMEOT ATE SuOdsOtHATES 29 NOT Fadacen®

POATTONETIAS Set Ore att and wAEO contr, CooBo TAO oe

1 Svosessante

wie ke

ao bands peme et ate Suactot sated Fedkuce wemaede oe ter Gerasrta see

~ I
ECRET Potential aw

fomw sa,
bude SE


14-0000

a

. SECRET
Qhen Filled Try a)
MAS BEEN UNOFR YOUR SUPEAVEGTUN

JAY 29 = py
209 PH ap

Ker potential has a wide range. She has the ability to organise and direct a sizeablo

office of reports writers and to supervise tho administracl4u Appgtions for a large

office. She has a distinct aptitude for operations and her poten fat in the field of
cperational aupport work 4s well as in the diroct handling of operationg ig a good one.

OF MONIES DOE RATLOO FMP OVE

APPRORIMATE NuMAte

CNOIKATE THE

7 months

2 CUNMENTS CONCERNING POTENTEAL

SECTION He . FUTURE PLANS
tT. TRAINING <1NG ON OTHER DEVELOPMENTAL TRPERIENCE PLAMNEO FOR THE INO I VIDUAL

None recommended at this time.

“TNDIVIDUAL’S GuTUBE ASSIGNMENT

TO O£ TAKEN INTO ACCOUNT th

3B. NOTE OTHER FACTORS, INCLUDING PCASONAL CIRCUMSTANCES,

DESCRIPTION OF BADIVEDU AG

SECTION te ve een bu
DINECTIONS: This section ia provided as an oid to deacribing the individual as you see him on (he job, Interpret
the words Literstiy., On the page below are a terios of statements that apply in some degree te most pesple. To

-Read each statement and insect in the tox the

the beft of each statement bo n box under the heading “catvpory.*
tolls how mech the atatencat apbies ta the Persona covers: Aotey thas eck vee,

WENCH GAN Arve HO UPINION AS To now Tek OCSLRIE TION ARR 1, “ia tH

gery f ruvnt ceowbdsh Jet)
Kis WAVE nor Ovusbavho mrss

iMGEVE DUAL
aPeLIesS TO tuk peer vr oyat TD THE CFAST POSSINLE OLGREE

APPLES To thwhWiouak TO A LEMITE® OFGRER
+ APPLEPS PO INDEVEOGAL TO AN AVIRA E GF UREE
= APHLCRS TO INDEVIOUAL fO Ay ANOVE AVEHAGR DEGREE

+ AMPLE S TO INDIVIDUAL TO AM OUTRTANDING OF GALE . 7

TTATIMENT

Ti, WAS WIG sravoRNOS UF Po
y APU OMPL IMAM ENT h |

ca

CATEGORY NUMER

Tan ene

Te sony

“BtATEMenT

Tt, #Bbe To Sat ANON A
ota oe vite

1d FORCE re Eke
S1OMS OF em Raazer aes

CAN WAGE G1 C1 SE9N% Ou WS. . faa, impciwints »
12, Swoas uAraimabity {
On tate mech AHL AES m i vAauit 1
. AGREP YS attrOn$t ante :
Ae MAT EME Pade u thes ° : ‘ h 22. EH fwousn ted GF DELS

Pee

Ae PO AMAL OPER PH WES ERE

wpen ss othe uate PAL Ture

fig. sesrenca wean to sure
videgn

rae
boras

STRIVES Coed tantly
wie uHvertvor ago

H
jis. ood wid soa eetwouT
ec t atNanG fuPrORe

Jee ee ee

Aoiu tions

Qo naga oni to Sean
AGSE stance

SECURE Te Lansctans

ra. oth

Samas ue
10 cece

Caeser te
cree

ftw. 8o sesh @vany

was urenae Foa aK

ann een ,

Face
trae Sf ah Ber ce

fig. tatead cobeace

nee ee

r0,

io Gbea tains oone

Cum core

ayte ema auncras

. SECRET

14-0000

CONFIDENTIAL ; i
(When filled in) ‘

NOTE TO PCS RETURNEES

Personnel processing in from a FCS foreign field assignment through
Central Processing Branch are required to review the Eloyee Conduct *
Handbook and the information for PCS returnees. This information is
contained in a notebook provided by the CPB receptionist.

PTET meee nna cen eee ime A oe ee einen

v

MEMORANDUM OF UNDERSTANDING

Io hercby acknowledse that I have read and understand the contents
of Handbook 2084, Employee Conduct, dated 9 July 1970 ard the infor-
mation tor returnees dated 1 February 1972,

-

COareT RD yr fat
CONS TDENT OAL

(When Silied inj


14-0000

/ . ON aN ay

INSTRUCT I ORS

INSERT APPROPRIATE COOE RUMBIO Im “CODE® COLuMNs =”
atrcay ootes sy using FF”

USE APPROPRIATE SPACE OFLOW TO MEPORT DATA FOR CITHER PCS G8 TOY,
TO O€SIGNATE WHETHER SUBMISSION 16 OF BASIC CATA, CORRECTION, Of CANCELLATION (One only}.
THE NUMBER FON THE MONTH, AND LAST Teo DIGHTS ONLY FOR YEAR, BEER TO OFT .NO, 88. REVISED.

1. pcs (Basic)
3+ CORRECTION
BS + CANCELCAT IOS

St me a nee erm ee ce eRe Ranch oe eS Hecemenmanerne

4. coratcrics
Os CANCELLATION

SOURCE DOCUMENT AND CERTIFICATION

: TRAVEL VOUCHER Dusratcs .
q ene ete ne en one ~ — a ren rena en eee
cAGLe OUTY STATUS OF TIME AND ATTENGANEE SLICRT

Orne (Specify)

Socuueny ett veatieW Wag TT gc bare Feta ae
: A OS eee

Pemanns

q

AaGsee Dea CERTIP SED CORMECT, GASES EPO SOURCE
BocuMENT CITED

wij steort samatsteo On
egerers oecument

SIGNATURE

THIS REPORT WILL BE FILED IM THE GFFICE OF PERSONNEL
1M THE IMOIVIOUAL'S OFFICIAL PERSORHEL FOLDER

d4a-59t

Cee W5pa pesctse eenviaes SECRET

aon tosttons


14-0000

- , som Ye : : ae
oe ee a, * SECRET ~; oO

FIELD REASSIGNMENT QUESTIONNAIRE

00 HOT COMPLETE FOR HEAQQUARTERS USE CBLY
nau OF EMPLOYEE (uae poeeuds onfy If SAJJOATEC from item S-Ulmamt of SuPERVvisSt® free) Oate (from item $-2)
8 Sep 1971

Charlotte Z, Bustos-Vidella 8 Sep 1971) John R. Horton
DATE RECEIVED AT HEADQUARTERS; DISPATCH MUMAERSY GATE RECEIVED BY CasttR SERVICE:
. HMMT 11,08
15 September 1971 8 Sep 1971
TO BE COMPLETED BY EXPLOVEE
1, OATE OF BIATH 2. vOu@ CURGENT POSITION. TITLE 4. STATION OF BASE b. CRYPT FOR
any ceade . CURRENT COVER
Nominal_—_..

12 Jan 29 Cuba/C!; GS-13 | Mexico City — LNGOLD
? 66, ors into oaTE TO REPORT TO OUTY
arrveRr ay

Se, REGUESTEOD DATE OF | 6c. EXPECTED CATE OF FIRS

iM FIELO oEraayuae CHECK-IN AT HQ .
. 7 6 October (3 weeks H/L)

@a. CATE OF PCB aRRival

28 July 1967 9 Sept. 1972 one--- (2 weeks A/L)

7. NUMBEA ANO AOLS OF DEPENDENTS ONO BILL TRAVEL BITH your

None

PLASONAL CIRCUMSTANCES THAT SHOULD WE CONSIDERED IN DETERMINING NEXT ASS sRomtnTs

8.
My husband is currently a professor in New York City, and I would very
much appreciate an assignment in New York City go I may ‘join him there.
I would xbe agreeable to changing Somewhat my departure date from Mexico
if it would help in.my accepting an opening in New York City. ‘My reason
for requesting the two month extension is to insure my 5 years overseas
duty so as ‘to qualify for tho organization's retirement plan.)
9. QUST YOUR MAJOR DUTIES CURING COPRENT TOUR (zee special note on ¢ranumittal form).

Falso attach personal cover questionnaire in accordance with CSI-F 240-8)
1. Analysis of personality and target data from raw and finished reports)

proparation of target studies, ard finished intelligence dissems.

2. Operational reporting: cables, dispatches, projects, progress reports

etc.

48." Handling of outside transcribers. (off and on). °

4. Records control and purge of Station files.

5. Proparation of merios for other components of LACUFF,

6. General Ops support IA typo work.

tO. TRAINING DESTRED: .
ENDICATE attaT TRAININGS TOU BELIEVE YOU SHOULD WAYE DURING THE NEXT Sk¥ehar YEARS

SECRET

roa 202 gaze tere oaqurous


14-0000

on

SECRET

11. POPFEOENCE FON REET Aas teomrat,
DESCRIBE DAITFLY Tue Tere OF SURR TAY BOULO POFSEO Fom weet SSS IGNer eT TF DEPP ERENT FROM twat bWOrCated |

Ite,
tm ete wo. ® avove, 18 YOU WAVE WOME Tram Ont PRLFERERCE, favICatt Youd CHOICE.

11®. INDICATE tf VOU OESIME TO BETENO YOUR CURMENT TOUN DY CHICE IMS 1a APPROPRIATE BOX. ALSO INDICATE PREFERESCE

FOR NERY AEGULAW ASSIGeMENT OY INSERTING $, 2, © 9 (for fat, tad. and Ind choice) im MIMAINING soxes.
COMPLETE ALL ALTERNATE CHOICES AND OPTIONS IN ALL CASES EvEw THOUGH YOU ARE ALQUESTING AN CATENSION: OF YOUR

your, | , 1
¥J 2 MONTHS AT CUNAENT STATISe 19 9 8epte .

envano Tous
, . a toured

BE AGKICHFO T. 86 FOR A TOUR OF DUTY: tHOIC ate CUDITE OF OFVISTON, or orrice,
2 3) Vat Cworce ‘Doi ane cwoiee UR sad cworce min

OM, INDICATE CHOICE OF SE OCRAPHIE AMER Of SPrCALIZATion

1D rat cwarer NOW Lor PTA, cove IRD CHOICE,

is? Choice

‘3 0) rerun ro wy cuneest srarion hop, oye

, : TO GE COMPLETED BY FIELD STATION
tM CONFTIOKRATION OF The FeeFeICNCE and PLAS ORWANCE GF THE FPL TTR AUD HIS FPREFTALHCE FOR NEKT ASSICNMENT,
INDICATE YOUR ALCCOMMENT AP ION FUR HES NEAT ASSIGNMENT AND TAAISIOSs

Those of you who know her realize that I would hardly give up
SCALETTI, even after five years on the job, without a fight, did not
other reasons intervene. Her husband is working in-New York now and
so hor romaining here any lonver than needed for her to qualify for he
retirement time, az she explains, is 4 needless hardship. (li would
holp us if you would confirm that time: ig that the date needed for

her to remain in order to qualify?) Pleage do your best to arrange
- coer om ee OTT ED

Torres EE Cea TED BY. APPROPRIATE HEACOASTERS OFFICE

IN CONSLOERATION OF THE EAPLA{ENCE AMM PEREGOMANCE OF THE CUP efE, HIS PRLFFREWCE £GR WUXT ASSIGNRENT,
“AND THE STAFFING REGUISEME ATS OF FOUR COMPOUEMT, INDICATE (Ou COMPONENT'S PECOMMCHOATION FOR HIS NEXT

ASSIGNMENT AMD THAIMING,
Subject will be assigned as chief of the CA Section, WH/Branch
ig

¢

Re

V2.

One, She is being notified via HMMS 75806.

‘pare Q5un72_

. FOR 3. BY AREER er ce

14, APPROVE ASS ICRU ATE

19, TMPLOVEL MOTIF ILD OF DIBPATE® 6,

CREE 8D reer nr crnnenwemeemes PRP O Sem,

CACTER GEAVICE SrPReseMTETi she
everrerrrs)

aE ear an. ae

te mr 8

or re


14-0000

a eae oad - - ee — te ee more
~ . os
a . ve ak Sell ke
. =, ee “~ - “
a; a. “ ,
~‘ we -

12, CONTINUED

an assignment in New York for her. She is such a valuable
person that anyone who has worked with her would be glad to have
her on the premises: so there is no need to try te "sell" r
her: it's just the question of whether the timing would be

right, I should think...

ee a

eet mee pera

14-00900

swegrsenin

fe bana one

sys

PLACE OF RESIOENCE wHew INITIARLT EMPLOYED BY aoe

[MEME OF SPOUSE

—™

7" CONFIDENTIAL.

(hen Filled ny

tanglete in original, -The data recorded on this fore 16 ancestral in Cetermining travel expecses silowable in con-
eaztion with heave at government exrense, oversees dots, return to residence upon separation, and for providing

current residence and dependenc

Washington, D.C. ee ny Dele

PLACE IN CONTINENTAL U.S. DESIGNATED AS PERMANENT RESe | HOME LEAVE RESIDENCE

CENCE Dayton, Ohio on, Ohio -

1? MARRIED, PLACE OF MARRIAGE

Dayton, Ohto

57 DIVORCED, PLACE OF DIVORCE DECREE

RA

W- WIDOWED, PLACE SPOUSE DISO

TA

a x :MEMSERS.OF FAMILY | -

Cesar Dustos-Videla

} SAMES OF CHILDREN AQDRESS
HA : .
DBEME OF TOUR PATHER (Or male guatdtian} ALOIESS
Gaouel D. Zehrung m | 4°5 Dayton Z 7
eau OF TOUR MOTHER THER (Or female & guardian) ACONGSS

Fezel Zehruny Bites

: A ne Parsee
onat weMaeRisi 0. OF YQUR FAMILY (F ANY, MAS QEEN TOLD GCF £fOUR AFFILIATION with THE ORGANIZATION | rs “CONTACT | 1S.ge-

auiaeo- IN AN-EMERGENCY,.
*

SAVE (ede. Mra., Miva) (Laat Firseatiddte)

Cesar Bustoc-Viicla .

ADDRESS (He. Streat City, Stete,2ip Code)

Aparte3n Postal E-940, Mexico 6,D.F.3

rs br, Dayton, Ohio

ue Bae

“TRELATIONSHIP

husband

information required in the event of an employee emergency, This form will be

f. lod in the employee's officiel persannel folder.
tag OF EMPLOVEE {Leet) (Pireay Otiddie)| SOCIAL SECURITY NUMBER .
z BUSTOS-VIDELA Charlotte Zz 069-2h- 3138 :

ce oF ESIDENCE iN CONTINENTAL ULB. (I appointed

TeLerHona NOMEAICO.
ICO 525<42-36
SEX DATE OF BIRTH

TELE! HON NO. a

HOME TELEPHONE HUMBER

Owe AUURE $5 ( (Ko. Tsteoet, City Stata. 2in Cade)
Bee above .
BUSINESS AODRES: eStrect. Caty,

MEYICD

Univecsided de las anericae, Puesola, MEAICo

EVPLOY

pj aad Demet

see ehave

fauna be believes you work far.)

eS

cS TMIS NOTVIDOAT “AUT MORIZ & To vaxg MS
sing name ond oddrona af porvon, Ut any, ate cat inahe such eran e m1 casa of serergincy.)

1S THE INOIVIQUAL NAMED ABOVE @IT TING CF YOQUA AGENCY APP isa THK? {it *Xa° tive name ang athirona af organisa-

Se MALP IN THE-EVENT ¥ VOU"ARE INCAPARDLEF (1 No" [yes ©

£ & EX SFERSION

nO

eepan why in item 6.)

cow TINe, a NW HREVERSE SDE

Forw gy yak eue vious CONFIDENTIAL

8-8? CTO,

CURRENT RESIDENCE AND DEPENDENCY REPORT

SOTt THs3 INDIVIOUAL SNOW THAT WE NAS QDEN DAVONATED AS TOUR EMERGENCY ‘ADORESSEE? ‘(Ul emqncor ia No" . Lxes ‘
‘ ast

Tha persons named In item 3 above may also be notllied in cose of emergency. IF SUCH NOTIFICATION iS NOT DESIRABLE BE.
CAUSE OF HEALTH OR OTHER REASONS, PLEASE 0 STATE IN ITEW 4 ON THE REVERSE SIDE OF THIS FORM.

‘ay

It

14-0000

CONFIDENTIAL

(hon Filled In)
a . VOLUNTARY ENTRIES a _
Experience in the handling of employee emergencies hos shown that the absence of certain persona! data often delays and compll-
cates the settlement of estate and financial matters. The information requested in this section may prove very uselul to your fomily
or attorney in the event of your disability or death and will be disclosed only whencircumstonces warrant,
INDICATE NAME AND ADOREBS OF ANY DANKING INDTITUTIOND WITH WHICH YOU HAVE ACCOUNTS AND THE NAMES IN WHICH THE AC-
COUNTS ARE CARRIED.

All financial information 1s on file with our lasyer

Mr. John DAHLOREN
DARLGRES DARRAGH & CLOSE
IONE conn. Ave. W., Washington D,
ARE YOU A MEMBER OF THE NORTHWEST FEDERAL CALOIT UNION? =f) Yea [x] NO

i? YER, OO YOU HAVE A JOINT ACCOUNTE cow Ce

te me Le .

NAVE YOU COMPLETED A LAST WILL AND TESTAMENT? El ves cl NO. (TE *Yes” whore fe document located”)

Oa flLle with lawyer listed above . ”

TER TO GOTH PARGNTET

HAVE YOU PREPLANNEO AN ARRANOED QUARDIANSHIP OF TOUR CHILDREN IN CASE OF COMMON DISA
‘m) ves Cl NO. (If ¥en" give name(s) and addrese)

NA
HAVE YOU EXECUTED A POWER OF ATTORNEY? — co vas an ao ame
Believe the lawyer has this also :
ADDITIONAL DATA AHO/OR CONTINUATION OF PRECEDING ITEMS

5, who possess the power of attomoy?)

3 boo.
we Bin 08 Fe | c Litt a Ct ee

CONFIDENTIAL

SIQNED 4? oe 7 [ers [signarure


14-0000

pete ame

‘ oN
ce a? .
i
; “ a COMP) EMTGAL
a: (when Filled In)
a oo.
by NEMORAKRIUH OF UNDERSTANDING
g I hereby acknowledge that I have read and understand the contents
a of Handbook 20-4, Employee Conduct, dated 7 October 1963, and ‘the
Fe information brochure for PCS returnees, dated May 196k.
FY “
q
4 4 3
22 | eres (Efe
\  BUOIKB Mdelu, Charlotte - . :
\ CONFIDENTIAL
1 (When Filled In)
\ ‘
4

enn aoe ee rene eee ene ee ee eep n enet


14-0000

Do St SECRET

. FIELO REASSIGNMENT. QUESTIONNAIRE
_ CO ROT COMPLETE FOR WEADOUARTERS USE ORLY

arlo Bustos-Videla ames B, Noland
DATE MECEEVEO AT wh aOQuaRTEREs. DATE MECTEVYED BY CAREER SERVICE?
1OAPH ‘
be70

“1010
TO GE COMPLETED 6Y EMPLOYEE
Titec 4, STATION OR BASE

Feb, 1979
cavet or
Cusment cover

YOUR CURRENT POBITION,
AND GRACE

Exec Assistant, GS-19 MEXICO CITY Station

$0. COSIRED DATE TO MEPORT TO BUTY
AFTER LEAVE

1. OATE OF Bratw FC. senvice! ds.

Tourist

EUPECTEO Gate OF FIRS
CuECR- te AT HO

8. REQUESTED DATE OF
DEPARTURE

16 Aug 1970

pate Oo ARRIVAL

tm F1Gu

28 July 1967 W411 not go Hdqs| 26 Oct 1970
. : unless requested

NUMBER AND AGES OF DEPENOENTS WHO WILL TRAVEL WITH VOU

Y

none ‘ .
B. PERTOWAL CIRCUMSTANCES THAT SHOULD BE CONDIDEREO IN OF TEMMINING KENT ASSIGNMENTI
Subject wishes to remain overseas for a minimum of {wo more years to

complete her 5 years overseas requirement.

9. LIST YOUR MAJOR DUTEES OURING CURRENT TouR (aee special note on on tranamittal form)
(aleo attech personal covor questiannalire in secordance with C5E-F 240-8)

H L.

: In this job she also handled some Cuban operational matters

: including two outside contract em; luyees.

: 2. uring this period she also handlea some sensitive projects for

the ccs,

: 3. During the last six months ‘yubject has been Exec’ Asst to the
CGS/DCOS concentrating on file and administrative recrganization

of the Station,

Subject has had supervisory resconsibi lity over one to three
elericalsTvUY staff for short periods.

10. FRarwing C&S dmED:
PYOICATC weal TAATWING YOU GELTEVE FOU ANOULD WAVE DURING THE HEAT SEVERAL YCARS

‘None . .,

yee pag eee Te SECRET

3

During most of Subject'!s tour in Mexico she has been the Cuban IA.


14-0000

rm,

DESCRIBE GMIEFLY THE TYPE “WF @0MR VOU WOULD PREFER FOR NEXT ASSIGNMENE JF DIFFLSENT FROM THAT TMDICATED

Vie.
tH ITEM NO, 8 ABOVE, If YOU MAVE MORE THAN ONE PREFERENCE, FNOICATE YOUR CHOICE,

I enjoy both Administrative and Cps; IA work.

INDICATE 1F VOU DESIRE TO CRTCND YOUR CURRENT TOUR GY CHECKING IN APPROPRIATE BON, ALEO INDICATE PREFERENCE

ROR NEXT REGULAR ASBIGNMENT BY INStATing 1, 8, 8 3 (for det, dnd, and Ird choice) tM REMAINING BONES,
COMPLETE ALL ALTERNATE CrOrlrcés anO OPTIONS IN ALL CASES EVEN THOUGH VOU ARE REQUESTING aN CRTENSION OF YOUR

tour,
r .
3 a) exrenp tour: 2” outa ar cunncat srariow-vo— Aug 107],
' . . . (oats

BE ASSIGNED TO wOoQgTas FoR & TOUR OF DUTY: INDICATE YOUR CHOICE “oF DIVISION, STAFF OR OFFICE.
BND CHO bCE men, FRO CHOICE

(aT CHoIce
oc ASDIONFO TO ANQTHMER FIELO STATION: INDICATE CHOICE OF GLOGRAPHIC ARTA “on SPECIALIZATION
ist cnoice ~ IND CHOICE, gan cnoice

vP
ood

agtune TO My cuRReNT statrew fOr 2nd tour.

’ . TO BE COMPLETED BY FIELD STATION
U2. IN CONSIDERATION OF THE EXPER TENCE AND PERFORMANCE OF THE EMPLOYEE AND WIS PREFTAENCE FOR NEAT ASSIGNMENT,
INDICATE YOUR RECOMMENDATION FOR HIS NEXT ASSIGNMENT AND TRAINING

Would not stand in subject's way, were she to be fortunate enough to
get a laris assipnwent. However with her dong waxdico background (both
Hdqs and ficld) and her multiple talents she has been invaluable in the
reorganization of this highly complicated Station under changed
circumstances, will ecntinue to be so during the next neveral years
and to lose her. would be like losing one's right arm. Theretore we
strongly endorse either a second tour or an axtension.

— ""~TO SE COMPLETED BY APPROPRI ATE HEADQUARTERS OFFICE

TN CONTIOL GAR IM OF THE TAPER ONCE AND PEAPCRMANCE OF THE LYPLOTEL HES PREFERENCE £09 NEAT ASSIGNMENT,
AND TRE STAFFING REQUIMEWENTS OF YOLK COMPONENT, INDICATE YOUR COMPONENT'S RECOMMENDATION FOR His NEAT

ASSEGHMI MT AND TRALNING,

Vi Division recomands that subject retum to Mexico City for a second tour,

vate 22 Mar. 29. hee Cad Fers_ SIGHATURE

FOR USE BY CARER

Us. APPAOGED ANS IGKMENT:

_New Cour in Hexice _ en . oe
Bema: SRO aE

rs, CuPLertl NUTID ORD OF Gishatcn mo, Wo:

Cet sO. Dare

BE Cece teemraniar am ee Mie

Sanit s steele COPE StRTaAt bees. .
Ceeaeateeed

Se eannine tadeaarenematbantetemenaan

SECRET


14.90000

CONFIDENTIAL

. Cithen Filled Ind

Casplate in original, The data recorded on this form te aasentinl in Seternining travel expanses alloerble in cone
nection with leave st government expense, overseas duty, return to residence upon peparation, and for providing
currant residence and dorendoncy information required in tie event of on employee amergency, This form will be
filed in the employee's official personnel folder,

(Loat) (Feeat) *

(Middle) SOCIAL SECURITY NUMBER

NAME UP EMPLOVEE

Tom,

“Bus70s ViDELA Manda A006
- facet ee RESIDENCE DATA :
PLACE OF RESIDENCE WHEN INITIALLY EMPLOYED OY | AGENCY Laser ‘woace oF RESIDENCE iw € CONTINENTAL U.8. (I appointed
ateood) wv A
: Puree rar, ove

QoAcHseroW De,
PLACE IW CONTINENTAL U.S, DRSIONATEO AS PERMANENY RESE
CENCE UV ASHNATON DC

MOMR LEAVE MESIOENCE py?)
Creve ttepD OMf0

vivonceo

17 MANSIED, PLACE OF MARRIAGE

“DANTON , Cw o-
id DIVORCED, PLACE OF DIVORCE oaecrag

17 WIDOWED, PLACE OPOUSE DIEGO
WA . . ' .
pe ea ee nner en et tte an
ANO DATELS)

kobe oMEMBERS OF FAMILY : _ . _
ADORESS (NO Sereet City, State, Lip ¢ Coda) TELEPHONE NO.

LAS ADUBOCAS UVAL, A4ENCO Orn HEY

eee sex | Data OF IRTH |

HAME OF SPQUDE

CaosNz  “Basret-wineta

AOORGSS

—--— tH.

: pores aw? FF DACA Esper e 235 Trevernonn wo.
‘2

WRME OP GUR PETHER for made gundtan) |
SU Ek TO REY IN O

On (Or kunuie euacdion)

teed DT LUuELTE SF oe Mati. Be
EE a Sk AL ec ne

BoOOHESS TELEPHONE NO,

“WaT GP YOUR MOTHER (Or

HAL Lod PEMMUN En
“way Veunents 19 yYourR FAMILS I va Any, Was. BEUM Taco OF ‘Your AFFILIATION ® wir He ORGANIZA TION a2 CONTACT rT)

DURE 11 ATE EULHOHACY,

Ef pity BOE phy of x pps. A oD aon bsitgc eee AE a fy :
“beRson TO 08 NOTIFIED IN CASE OF EMERGENCY ee

eee ee so paced “[Retarionsme

3 CRP id
Hee

NAMh (hr, Mracy Mine) ‘CfauetoPientstiddto) : CC

REE Eline, Mary bhrrabetle Tree

“Woe BDUNENS tsa Bereal “Gitr State tip Code) TT OME TELEPHONE NUMBER
ou tite 1 26G- £71 -06$ F

Lae ha Fouesr wae, CAL vette,
: Btewet, City St Ste Zip Code) AND MAME OF EMPLOVIR, IF APPLICAELE | BUSINESS TELEPHONE A EXTENSION

MS TRE INCI vIDUAL NAMEQ | MaGve wit tino OF YouM AGENCY APPILIATION? (If Mu" give name and addroas of pereantaa | ves.
tees hg bettarae yous work t
af? ‘hs ceethe fet ser7

Prin i. Ltbhew 5 uh Leek el

ne a en ane

1S THIS ISNOIVIQUAL AUTHORIZED 70» MAKE DECISIONS ON YOUR HEMALF ih yi EVENT you AA AAE “INCAPABLE? reer
Give nane od abireae of perecn, WH ahy, why cat makn such docletune by cuse of emergency.)

faarg ty tr hb OL fj beet te aise wae SY ecg tt had wp ahee.

oat Ale at. 7 bd sene,
Fels INWIDUAL KNOW THA
eazioin why We then 0.)

DESIGHA ze] aa Yi You

eee te te ce eee

Phe persons nomad In om 2 obove may olan bo wavihed in case af emergency. IF SUCH NOTIFICATION 15 NOT DESIKASLE BE:
CAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE IN ITEM 4 ON THE REVERSE SIDE OF THIS FORM.

ia)

Feow gy we PE WIGS
-ag 2) Kariges,


14-0000

CONFIDENTIAL
(When Filled Inj- .

__VOLUNTARY ENTRIES

£ sperience in the handling of employes emergencies hos shown thot the obsenca cd covtain garsonal data alten.deloys ond compli-
cates the settlement of estote and financial matress, The information requested in thes soction may prove very useful to your lomity

os ottcaney in the event of your disability ov death ond will be disclosed only whencwcumttcnces warrant.
epic ay f WHICH VOU HAVE ACCOUNTS AND TRE NAMES IN WHICM THE ACH

INPICATE HAM ANO ADORESS OF ANY BANKING INSTITUTIONS WIT
+
ee’

“dr vtaclear at Kank 4) QWaalew oft. ’ Megat nd” Ciaete Sibausle, Cashin jin
sont dterund exit Audsbaud ) : ; . o
Oberntee Jugirat phar rrign » Kean! seer $201 Jusce Gwe MW, 0.6.
_  Gftrk asenwer avech Atiobaut, .
ANE YOU A MEMBER OF THE NORTHWEST PRDERAL CRADIT UNIONE we ETT) (7} Lad
cores

ea) ves [7] NO. (il "Yas" whore te docamnord located?)

1F ¥89, OO YOU HAVE A JOINT ACCOUNTT

v@ vou comPLeren A LAST WILL BNO TesTAMenr?
CR igi 2 Hb Yeviee f/ atte.

nate Lander Baive yee VElost.
, . 7000 Herm aqua, (rut

HAVE YOU PREPLANNED AN ARRANGED GUARDIANSHIP O1
Cc res QO NO. {11 “Yee” divo nomele) and oddreeo)

“

Ff YOUR CHILDALW I CASE GF COmsctH DISASTER TO BOTH PARENTS!

, [wave vou execurad , POWER OF ATTORNE YT v4 YES [| NO. (Ht * Vee", who preaeea ae power Of qitomey?)
for BL HG 2. le Hated nd? Aik of gtndlati ys VIP~ - —

ADDITIONAL OATA AND/OR CONTINUATION OF PRECEDING ITEMS

CH

Toave Sons TUSE

a - . H ‘ ? uu v re
een IE ILD) Chg aap tap A fliaarhn. 34 lie a.

7 CONFIDENTIAL “

14-0000

_wavakl
IMPORTANT

' ELECTION, DECLINATION, OR WAIVER |
: OF LIFE INSURANCE COVERAGE | AGENCY INSTRUCTIONS
FEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAM | ON BACK OF ORIGINAL

t

TO COMPLETE THIS” FORM—

FOLLOW THESE GENERAL INSTRUCTIONS:
* Read the back of the ‘Duplicate’ carefully betore you fill in the form.
* Fillin BOTH COPIES of the form. Type or use ink. .
* Do not detach any part.

FILL IN THE IDENTIFYING INFORMATION BELOW [please print or type):

| we tt)

(Bue tos<Videla
"EMPLOYING DEPARTMENT OR AGENCY CO Late 7 | LOCATION (City, State, 21° Cogs)

(frst) ———=SS=S*S*« Rw) === «(DATEOF BIRTH (month, day, yoas) | SOCIAL SECURITY wuwaee

Charlotte louise January 12, 1929 069 | 24| 3138

MARK AN "X" IN ONE OF THE BOXES BELOW (do NOT mark more than one):

Mark here
if you
WANT BOTH
optional and
regular
insurance

Mark here

if you

020 NOT WANT
OPTIONAL but
do want
regular |
insurance

Mark here
if you
WANT NEITHER
regular nor
optionat
insurance

COMPLETE THE “STATISTICAL STUB.” THEN RETURN |
THE ENTIRE FORM TO YOUR EMPLOYING OFFICE. |

, SGhATURE Gs at 68

t

| 42? sp,
i¢ CY (eign ele 3 fetta Fore Li:
1 ~ FT

SIGN AND DATE, IF YOU MARKED BOX "A" OR “C", |

— ELECTION OF OPTIONAL (IN ADDITION TO REGULAR) INSURANCE

““fetect the $10,000 additional optional insurance and authorize the required deductions

; from my Salary, compensation, or annuity to pay the full cost of the optional insurance.
\ ie optional insurance is in addition to my regutar insurance.

arm ,

DECLINATION OF CPTIONAL (BUT NOT REGULAR) INSURANCE

f decline the $10 COO additional optional insurance. { understand that | cannot elect op-

tional insurance unt at least 1 year after the effective date of this decimation and unless
at tha time i apo fer it 1 am under age §0 and present satisfactory Medical evidence

of insurab:lity. | understand also that my regular insuraceg is not affected by this dec!ina-
hon of additional eptiqnal msurance, -

WAIVER OF LIFE INSURANCE COVERAGE

| desire not to be insuréd and | walve coverage under the Federal Employees Group Life

insurance Program. | understand that 1 cannot cancel this waiver and obtain regular in-

Surance UAL & st Lyuar after the effective date of this waiver and unless at the time

1 apply for msurance Lam under age 50 and present satisfactory medical evidence of in-
€C) — surability. 1 understand also that | cannot now or later hava the $10,000 additional
optional insurance untess | have the regular insurance,

FOR EMPLOYING OFFICE USE ONLY

fettucial receiving “date stamp)

i
1

|
|

| QATE

ORIGINAL COPY—Retain in Official RPO EF

| . 3 February 19638

See Tahie cf Eftective Dates on oa ach cf Ongena!

a vet
He U on wht Aged 18, 1968)
meee ee DENT

““


14-00300

i Cem oe

fo - SECRET

(When grilled tny

. REPORT OF SERVICE ABROAD

\ To: : :
‘ Office of Personnel, Transactions and Records Branch, Status Section

en

MIDOLE

(Priat)
BUSTOS YIDEIA

INSTRUCTIONS

USE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. INSERT APPROPRIATE COOK MUMBEM Im “CODE COLUMN
REPORT DATES BY USING TF”

TO DESIGNATE WHETHER SUBMISSION 18 OF BASIC DATA, CORRECTION, OF CANCELLATION (One only).
THE RUMBER FOR THE MONTH, AND LAGT TWO DIGITO ONLY FOR YEAR, REFER TO OFI WO, BO. REVISED,

PCS DATES OF SERVICE

_ TYPE OF DATA

t+ pos (Bacte)
3. cammection
6 « CANCELLATION

2. TOV (gesic)
4 + comarcrion
@ + CANCELLATION

QFFICE OF PERSONKEL USE OHLY - PUNCH AREA

: | TRAVAL VOUCHER
Cae

area (Specify)
OCUMENT DATE/PEMIOD . — ~
2 = 29 JULY 1967 ~~ -

a ee

4 DSCUNENT TOENTIFICATION hu,
FORM 76)

REMARKS

SSE

ARRIVAL DATE TSPORTER UNDER "OTHE? BRMARXS" ON DUTY STATUS REPORT.

BBG1E DATA CERTIF 1ED COPATCT, DASEM UPOM SOURCE

PREP ARTO bad PEP oOT sanararne ae
SOCUMENT CITED

Canreo, GOcuMEeF

€¢ & bh De¥satow. crga, TIGHSTUNE
loa pone. 1S APR 1968 Sam
‘ THES REPORT WILL BE FILED IN THE OFFICE OF PERSONREL
th THE IMOLYIDUAL'S OFFICIAL PEASOASEL FOLDER

goey WuSta gina "re SECKET [se] tases
4 painted

14-0000

fe rs
". ‘ SECRET aad - -

. ”~ . When F Sef det an OFFICIAL USE ONLY (rot fifi?
8

QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT

er
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING ENFE OR PRINT AVOID USING LIGHT COLORED INKS
BIOGRAPHIC AND POSTON DATA

: 7 POSTION THE ane © OFFICE OF ASECNMENT TTOCATION ‘Covers, Gr)
: .0PS OFFICER wH MEXICO CITY
a Ss a

‘
B MOEN SE ASREERYICE ,
2 g
i Mékico. Gath | STATOW tt toun],. 2} Jund 1962 posune 477 | |
i "awd doar . (Ve
y i
2 H
i r
!
, :
3 H
i ;
4 . .
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: { :
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SECHON ~ ; TT _____fOUCATION ; _ ° _—_
pecsee  [< marceFiiD | SS~S~S ees, vua ,
ne A enn ee - 4
GACH —_ SEvER@Aal i SYRACUSE UNTV IY 50
: { | |
: | | :
tert SECRET er won
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14-0000

6
ad - ee a one rd rr rs aoowes - at ~
’ f |
: Voss Sts SECRET .
2 . _
F : . } UW hen't fed In’ an
! SECTION & J MARETAL STATUS
VORESENT STATUS th age Movred Witowed Senmrne Ovoried, Manvliod Benning SFELAY
2 NAME OF SPOUSE tow See ede’ fn tthe den
MAIS Vipera Cesac —
2 Gare OF Bin} 4 PACE OF DR Cy Dee Ceente
Feb 27 1922 SAN JUAN AKEEATMA
7 3. OCCUPATION © PRESENT EMPLOVER ;
. . Gholula, .
Pla FE SSO Loy verssb4D EG KAS AMERICAS Bee MEXicu} !
7, CHQENSH® . \ © FORMER CIZENSHIE,S COUNTERS @ DATE U. § CITZENSHIP ACQUIRED .
Usa vig uvaly weg! Atine : 1956 ; 1
SECTION . NT CHILDREN AND DEPENDENTS OTNER THAN SPOU ° :
aa waSonme | bak ne Rat oF a

iF
I

ewer nanan re atten te matt tiie tenet RNAS 5: mE a tem yannee +

if
| enn nveaen
|
i { i
i nt net arene artnet at ene eee
i j
i |
H — t a eae ;
i
, { ; . :
a a SE ne werner tent ee —-- ;
' SECTION XI PROFTSSIONAL SOCIETIES AND OTHER ORGANIZATIONS _ . ‘
— as DALE cre WEMBERSOIP
NAME AND CHAPTER ADDASS aweper, Sheet Cry Shor, Covater! From tO

|

|

+
|
|
|

i a ere ee ne Se :
i se ne ! voce ee *
| se sop
i
: Pe or i
i H :
: Date | TGNA US OF EMRLOVEE i
i 4 : : ” Ae, ;
: we Cea a cd | Cha a& fete yo Speer Pd eet ek :
{ tee eee en. i
SECRET
~7e

ree
aaa

14-0000

CERTIFICATION OF LAMIHAGE ROP LCIENGY

TYPE CHANGE ly LatauAGE CATA FRIOKS re ATA Fotse 16 Feat

: f
~ divin
rene ware te 1c

cate or pintn [E.onae |) orrice 96 civision |

O. ON THE DATE sHOwN IN trem 6 ABOVE, (OU WCRE resteo in SPANISH: (NEW WORLD) _RLUS 7
ARE AS FOLLOWS: NAME UF LANGUAGE.

TL eMPLOTED NS.

LAM, COUR

LANGUAGE

DATA AFTER Trot

AND (OUR TEST SCORES

TEST Q 7 Zero LT INTCRMEETATE

r. B37 atant HT NIGH
RATINGS € = cursenrasy N 2 NATIVE

12. SIGNATURE

| Rb

CL BY 017470 * i 13. LO momoen
EX-2 IMPDET Lod - 20723

. REMARKS

es
A te Mpepee eet teeta?

ODSOLETE PREVIOUS
CoITIONS
DI QLT Sie ieee CONTETH- 2026 10143"

le OP/QAR

THC DATA above (ircHs 2 tHeau 5) witt Be FILLED IN
WHEN CODING AN APPLICANT FOR THE FIRDT TIME, THs

FORM I$ THEN ATTACHED TO FORM 1962, 4ABDIER QUALIFICAS
TIONS CODING RECORD,

wren rorm Whe penores no LanGuace
Gaaencn Coe ENTER THE FOLLOWING 1M
irem br "NOFFLANGUAGL" (12-016176)}

GeLeTICNS

A Bus

CATA #OR (TEM 2 THRU] is
ExTRACTES FROM FORM V2TR,
Lancuase PROFICIENCY Ani's #}
AVAHDS DATA. un

ECORD CHANGE
ocr "type"
ADOITION 10 RECORD
CHANGE TO EXISTING ACCORD
BELETICN OF OATA FAG C41 STING RECCAD
~ econ #2

:

—-

teva 19624 SECRET  [(

A ee SOS AE * OS

veeaee


14-0000

SECRET 7

(WHEN FILLED: IN) ;
La ’ :
CSRTIFICATION oF LANGUAGE PRUFICLENCY
Lanecoves no fe. Nate (LAastericstemooue) U CANGUAGE CATA PRIOR Te TEST

LAN. COUE Ps [vu fi/t[vcan

RUSIOS-VIPELA, CHARLOTTE 2,
LANGUAGE DATA arTCR Tost O Gate Testo cate or aint | 6 anane |9. orrice on CIVISTON

LAN ni P W/T] year
add 06/22/67 orf/12/29 - ,

NOTICE TO PERSON TESTED
0. CN THE DATE SHOWN IN ITEM 6 ABOVE, YOU WERE TESTEO In SPANISH (NEF WORLD) ALIA

AND YOUR TEST SCORES ARE AS FOLLOWS: NAME OF LANQUAQGC

™ ZERO | = INTERMEDIATE

. prssaorancine egy 3 ™ suiaut H @ IGN
. f & ™ CLEMCNTaRY N @ NATIVE

. REMARKS 2. SIGNATURE
i FOR
4, QUALIFICATIONS : 13. LO nuMeca
oye DATE_ sy aug , * 1hé8

FORM OBSOLETE Prtvious . GROUP 1
Vb 1213 gotrions (10-48) SECRET [uaseogetitd eros) 1 = GP/QAB

Hike, IVE RAR Re Su e

LANGUAGE PROFICIENCY TEST OATA
_LANGUACE DATA BDEFCHE TEST

‘
+ teammate

DATA FOR Item O THRU T 4 !
EXTRACTLO rom iM t27 bie

LANGUAGE BHOFIC! trey ano ;
AMAROS GATA, 2 Of 86

QUALI ica TIONS REGERD sta

PUTER UNOCHR “Type” -
A = ACDITFON YO RECORD

Co + ChaNSe TO CxISTING RECORD
ign 6 OF CATA

FROM EXIKTING RECORS

ROO

14-0000

SECRET “,

CY whan titediny

LANGUAGE PROFICIENCY AND AWARDS DATA

10 Dart OF hate

~ oon

Roe al Witting’ (38) PRONUNCIATION (38)
tony 7 tf

: TVPE OF AWARO
mmr Tee :
AOEVUMENT (AD SASEO ON TRAINING IMHATwad
RATAEDIATE . DRSCTED (6) O8 VOLUNTARY (V)

(CERTAY ted EWR OVE ROR A RORY AWAID OF 6 1€4) UC 0-43)

RENATO Bi

17 1 CERTIPY THAT FUNDS Akt QUARAELE

SECRET naa MRD COPY

a

Poerpeemesremnsenmememonenimte terme tciemre mn ——

14-0000

te oe

2 e "SECRET “ att:

_ : - ig then Filled tan

“Yer PEREGUIC SUPPLEMENT . rn Ture DATE
PERSGELL HISTORY STATEMENT = omy ' 1 10 Septerior 1957

Tait form provides the means edesahy yout efhiaral personnel pecdede et qt be begt current, Even thevgh if duplicotoe
tion you Rave furn d privinwety, at Hibs mepeeaaer for;meu ty complete Sesticup A throvah YL to these

. Vou need caapte Sectione Vif theough Ali? only shames bob Oy LB no then since you entered on duty with
the orgenteation or af you believe the shew coquires sore complete Sivek bgp than you hove previously reparted.

Fula mamt ¢

SGHRUNG, Charlotts L
a. CURRENT apomess (No., Strood, City, dene, tate) 2. PERMANENT AODMEDS (We., Street, Céty, Lene, Atate)

3817 Davis Place, Ni. 4., Waahington | 5536 South Lixde Highway, Dayton 9, COhie
a. HOME TELEPHONE NUMBER O- PTATE, TERRITORY, POSSESSION OM COUNTRY 14 BHICH VOU Now CL ail MESIUENCE
En 2-1618 Ohio
SECTION 40. : rien Ty OE WOTIFIED iN CASE OF ENERGEACY .@
1, name (Loat-Piratece ) PREPT RAAT PEDUING Th ued. : a- wecare SHEP
Father

2 AUG el Daa ss BDA we __
3. wOME anuRess (No , Strest, Chty, seas, Stade, Counteyy,

36 Youth Dixde bistyey, Dayton 9, Chia
4) BUSINESS AUORCES (Neo. Street, Carty, Looe, Stete, Country: ANDECATE Name OF f10w Of IeMPLOYER,

536 South Dixie Hixwey, Dayton % Ohio. San Has Gardens
B. WOME TELEPHONE NUMER £ HU INE SD wt Auwate Te QUSTNESS TELEPHONE FUTENSION
VO 32-3511 : Hane

tf APPLIC ADLE

HQ 2-35} ;
9. tN CASE OF EMEQUENCY, OTHER CLOSE Sta ativas ( Wewee, Mother, Fatdery way Alt SE MOTEFIED, 17 SUCH NOTIFECATION
US NOT DESIRADLE OCCAUIE OF HEAL Te GH OIUEM REASONS, PLRARE SO STATE,
:

Sectiow 11)

tar

ren

Byker See,

Fy

vOrteed sore shan once, inclining snowleonta, ese # separate sheet for farmer sife or

fur add prave Ef merraage rovade oame tata for fiaaga.
eat)

(hail
4. GATE GP WAMHE AGE I Lace rf wsewiage (CHty, Stata, Gsuaters

—.-L a ee ee ce iene ee een enn nrencnneent nena arermennee

fyeg Manes ane, 19% Street, City, Ste, Cowncres

Spode: Ff yaw have devon

and tein

so sONNE AA OF Soo

Pe AtVING

Ty: oak oo tatu To. causa oF acat

Bee __. Tee

eOBwE SS tGave aref setresa, of Bevasaqdy

Hid. Peace Ge 8 eta (Cary,

— ETE —— sees

vie pare ce gtatn

TY. $k Bhan ce Taso Us TONITE uP

ite fF afadat 08 Weeeased of

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Near hoesas ihe,

eCard ata Qa

: SECRET a
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14-0000

SECRET .

Bree Filled fn
Stctiow il com TINUED FP DAS, Af ry
Tt. DATES OF MOLI TAMe SERVICE OF SPU gt EProes and Tus } ay womte amy ©

72> DRANCH OF SP M¥ICE 23. COUPE wit omic AEA THOR! Safe heh
24: DETAILG OF OfHEe SuvtAmMENT SroVied, Vib. OF TOsticn
. of Section tv RELATIVES BY BLOGG, MAURIAGE OR ADOPTION LIVING 4BA0SD 97 wHO ACE HOT U.S. Cra Tens e .
t- TULL MAME (Laet+Piret- -Middies ft BEL ATIONSRLP . Bs 6GE
4. ADDRESS OR COUNIMY ih weicm PLL ATive RESIDES | ue te +
: _ rf
Citizemaniy (Cowntey) @- #MEQUENCY OF CONTACT OATE Ce LaaT CONTACS
t+ PuLe wane (Leot-Piset-Middie)
OF COUNTRY F%
cc
4+ ADDRESS Of COUNTRY Im WHICH MELATIVE RESIDES
B CIVITENSNIP (Country) Ser Taney OF CONTACT 1 Uae orate CONTACT .
: 1. FULL FAME (haat sFiretMIddT oF 2 RELATIONS CEE
~ nooness Of COURTAY it aHICH PELATIYE RESIOES .
€- fegQurNcy oF CONTACT ;
G- SPECIAL REMARKS. $F ANY, CONCETNIGS THEST RELATIVES . j
yea
.

neem ene
HMERT UNDER ANN RETIREMENT Act

: ” OF SECTION V ; ; - — FINANCL AL, STATUS
or ae i nN - ~ oe
4 BRE VOU PNTIALL YS GEO ONDEMT 0% YOLM FEL ABE? [xl a
2,09 VO NAVE ANY FCNSNOEAL PREV AEST ra, UR OFFIC EAL CONNED TIGR ita, aon a LOSPGRATIONS OR BUSINESSES OF If 08
ONT US. CORPORATIONS Ge BUSIMLST£S WAVING SUBSTANTIAL FORLtéw sutines saz fo adres ej ao th VOU ASE
A®SWURED "YES. 9 Gan POULT E RETASLS ON A SEPARATE SMCLE AND ATEACH [fs & SEALED Bout hohe, :
ite ne oA NNN ee Re
2 ON YOU DECEIVE ay amenity FOAM tHe Se ETE STATES CR DIGTRICH OF COLUMBIA GOVE
PENS1 ON, Oh COMPINGAT IGG OR MILii shy Gh HAMA GhitviCe? “Jorars | no

ak TO HAVE ANTBERES 74k TO Gulgtrem 3 anowk, Give COMPLETE LitAu 3.

HAL See BST PMAICATED OY PAU CHDING FTES,

EMCE FS 7102- SAL ARE, STETE STHER SOURCES Ob” Ma Cumann es

BR eITHOUK AETe

SECTION ¥ COnfiautd 9 Phar oo

SECRET ;
. 2


14-0000

. : SECRET

PBhen Pitted fos

SECTICN ¥ COmTINULD Fotm PALE ¢

POF ED ET LT WEN MET Oo. week BLE eT
sruness (Ctty State, Cawntsr)

Beas iey

teu

nome pessin,

oF

Dayton, Unio

vase fagton,

HANERUP TONE
Utve PANT ICUs aes,

tm, OM PEISTIUMED the,
"VES" FF BUEbTICm F awuVe,

7% WAVE YOU EVER BEM
Oo. iF VOU MAVE ANSBERED

“Oth y ime COUGT AND LATE(S)

@] SECTION vt
1. COUNTRY OF CURRENT CiTisimiose COTAZONTHIP ACQUIRED BY > Catt ERE ONET
: us weeetece Cc) vtnre (Specaly y-
! 3. HAVE VOU TAKEN STEPS fo Cus TOP ’
POCSENT CITIZENSHIP? i om) “as (Z}«:
%- TF YOU HAVE APPLIED FU% lg. ESTES TMA Eh, INDICATE FRAGENE SPETLS SF COUR APPLICATION (Feral papers, ate.)
°
AAECe TAD MAST LEVEL OF Boulet ite aT TAINO
; | fee fee, uh tol hb ee + MD HECORE
fo freane. AVE WE SO, sh Crete fe, ae week She Riate auuet* stubs thattan wHicwre CfROnE
f COLLEGE Of Liivea sere ttoae
fabaedt DEGRE REN Th eles,
nhece COMPLETED
Tee tere (Specefy)
. a PCRS Gee Ak aD PEC Uae due Bf .
ann ene cst tem i en te TRA A Rt —
T { GATES abPesnes 5 fot as,
Mae Of 40nGd6 . + SILbY GH areci at rsatien oo :
: ! tune to nouas
— reer veneer saree ne earn trate me
' i ’ 7
i . ! .
a vee ees ee mere !
- ° 7 aan
. t “
eomeleneeneencth mipcennacnamnnm

ae sneer arena ateseneenaenene tn em me
feosteted aehvals iat a6 Dede anee, Fotedbagence, Cossinications, ef 3

Piamy thatmind (Fall teae titre 16 epee

4.
sateen anata aan eereenaedanioeninenaeeans gheeateenantaameraemmmnamcemmememmemmemmedtantmeae cmmemeent :
j y Oats Ente sa
“AML OF $C G3 1 ftulee OF SPET EAR USAT OCH o_o etree
. teew

a a a en nie reaaeT

so Diet poucabiywal Tasppean veil ont.

14-0000

Vo - SECRET

chen Filted Ja;
SECTIOA % CONTEAUEO FROM PAGE @

pee oe ee te — -————____ _.
YT. LIST Amy SIGNLEIC ANT Pup sho wateatAls. oe “sic vou agro tut AU THOM (be not sudert copies ealese reaurated)\
PHOICATS TITRE, PUBLICATION DATE, AND TYFE OF amr ting (None fiction, sctontelic artecios, genered entareet ay

jecte, novets, short stories, etc.)

@. tMOICATE ANY OLVICES @vlCw FOU MAVE FNVENTEO ANG BEATE BWCENLA ON NOT THEY ARE PATENTEO

‘ 9. GIST any OUBLIE SPEAKING AND PUBLIC RELATIONS EAPEMIENCE

10. LIDT AMY PROFESSIONAL, ACADFMIC OR MORCRARY ASSOCEATIONS OR SOCIETICS IM WHICH YOU ARE NOW OR CERE FORMERLY A
MEMBER, LIST ACADEWIC HONORS TOU MAVE AECK VEO.

$ IMCLUNIVE OATES (Froa- ond To-) “a. Geaoe!3 Ore icr/OIVISION/ORANCH OF ASSICAWENT . 4

27 Aug 51 = 27 Apr § DoP/WH/TL_(uqa

4. 89. OF EMPLOYEES UNOEA yOUR DIRECT | 8. OFFICIAL FOSEVION THTLE +

i - SUPEAVISLON ° Secretary (Steno). : ‘

4- DESCRIPTION OF DUTIES

rf 1. #MCLUSIVE DATES (Prose ond Tow) 2. GMAOL | 3. OFFICE/SOLVESION/GRANCH OF ASSIGNMENT

; }-27 Apr. 52_= 27. Sept 53 _. ~7_..1 DIP /AH/ 11 (Hqe )—--——--—_—--
: j 4 9. CF EMPLOYEES UNDER YOUR DIRECT JS. OFFICIAL POSITION THTLE
: 1 suPcavissoN? Intell (Rpta)
, 2 PWT Grsceiption oF OUTIES ~—— _ ~~
. Al) duties of Reporte Officer
Wo Tmetusiva ares (Prone and fooy PS Gaact [al Gretel olvi sions Haucn OF AGSIGNWENT un res

- .| L2? Sept 53-20 4pr 85 | 9: mpp/a/Ir Ce
? So. DF CMPLOVELS UNDER VORP nipeey * SF PRCHAL POSEFION THEE
. 1, THPERYISTON one to tro | Reports Officer _. _.
; , lho Uvseniption or opts ——————————— rs

1
an | Duties of Chief reporta officer af

i
: mare THCLUSIVE Dates ¢ Froo- and Tor) fe exes [H Ure versorvisian avancn OF ASSEGRMENT — ~~
(| | 20 Apr 55 = tune 1957 Ma DOP/M/IT (Hoe)

wa WS, OF TPL OVETS UNDER YOuR O1RECE { B. See rcdal eQarmiay trite
PSPUstON one = tio i. Gnlet Reporte Officer: et

6

Phe tmCLuSees DAtes G Pree ane Tes) he: Se aat re SP ice OTE I STOMA DIANEN OF ASST CAUESE

; June 1957 = present j A) BOPAWH/TIT (Hes)

Fe ee le ene te ane te
OPAC AL PUDEL LON FTE

fA NO. UF CewLOrErs UNDLa vOLR Oieect tte

- ff supsavisron i Roporta Officer

nn BO

BERIF TION GF Su TAeS

(tee etartigeel pegee of coated)

A.

14-0000

o
: SECRET
(When Filled Iny :
‘ SECTION Kit Ceikowee AnD OTHER OEPERDERTS Qt "5
— - : at aS ¥
1. MUMDER OF CHILOREN (Including atepcrsideor roNuMACE oe otace orvinoryts Cine todind spore, t ‘MP:
ete
(

and adopted childcon) mi ane uswaraicn. 4 to s08 OF
" ~ ’
UNDER BL YEARS OF AGE, AND AME NOT Sture tatae sunboet, oe cast net OEP S wipes |

SUPPORTING. i —~d. OF AGL ent ARS AG DBR SUP Pus “HD

PROVIDE THE FOLLOWING INFORMATION FOR ALL CRILSMEN AND ULPINOENTS

Save COMPLETES F - . Torgvan a

on
- £8 Lay 7 H fe ee OM wa Pa
, . SEGRE)
&

A


14-0000

(*

. "BO. CHARGE ALLOTHENT NO.
$9. STATE/DC TAX DEDUCTION $
22, umPcoves BAYROUL no,

21. NET AMOUNT OF AWARD $

23. FORWARD CHECK TO

- a . 7

24. ALLOTRENT OF ASSIONMENT

- |
2”. SECRET “y |
2 s : ‘ ) (Whon Filled ta) nh See
T Peasonnes cma aeheU OT 2 UN. |
tafe! ! LANGUAGE PROFICIENCY AND 4 AWARDS DATA 36 |
a COMPONENT 6. GRADE 6. CATE OF BATH .
nes . to fae Ut ye i
7. tanouaoa, 0 coce (G8-37) | 9 oaveor tes? YO. annwaesary Cate (20-34) ;
stay oaamal den TL tat
JJ. resrrurmrose | 42, _TEST. SCORES 1S Furosery {99).
seen REAOING 134)] WRITING (3B) | PRONUNCIATION (36) — UNDEHOTANOING (3971 AW sneame nor
7” > Lor, ' es {,i ! AWAnDAOLE
74, | CERTIEY THIS EMPLOYEE FOR AWARD
DIONATURE DATS
18 AMOUNT OF AWARD | $100 90
18, FEDERAL TAX DEDUCTION $

Fore
4.660

2D, CHECK NOY BATS
L .
1273 use PREVIGUS EDITIONS SECRET oan MRD COPY .
= rr rn Lae ‘ a ths

7 SECRET -.
acne emer ree ats - —Wten Bled
ai {LANGUAGE PROFICIENCY AND AWARDS DATA

ream

t mm TS SS RAONENE 8. GHADe—(G. OATW OF OraTH
' Saear ey lniwe ia ime et. 1, 7029
PT anauaan en See “Qo Bare Ge yest _ ; VO. ANNIVENSANY DATE (20-33) |
> _ yk Ree vg to ote
| ee = ce eC
i sa . TFS) scones _ I}, cuistorrry (36
awan READING (34) f wuitina 13H) | PRONUMCIATION 190] aPEANING 1571] ONDERSTANDING 1385 TAwampapen_| [ Nor
u r . z 7 Tal ty awamnanie
i 14. | CERTIFY THIS EMPLOYER FOR AWARD ; TPs OF AWARD
Gian ature : pate ars A.M Tene n- Wee o- v
. | on .
i ny . 17. LOSRTIY THAT PUNDS ARK AVAIL SOLE eee
| 16. AMOUNT OF AWARD Bric ay OBLIGATION ALF, NO, cones
i |
T] 18. FEDERAL TAX DEDUCTION $
| 7 “PRO cnanse DAULOUMENE nO,
19. STATE/DC TAX DEDUCTION $ |
emt Fa. amecores PAYROLL Hoe —"
if 24. 3
' 23. Foawans chsca TO a _— [FF SRST Foy sasionsnr 4,
| Pa? : Pras fe
SECRET tomes MRD COPY

lAvied s
woe 8o73 Lad tRaVIONS ECITIONS

iadeeetenne i ceteiearetaeeee ieee ee rE te peemmnaesatmnoe:
- aie ene tee tteee he a


14-0000

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SECRET

eWNen Fildied In)

PART 1-GENERAL
(as 301
oo .

1929 ‘

3 Date ’
wont vise
, 1 WAVE NO PROFICIENCY
April 1957 Cs ANY FOREIGN LANGUAGE

SECTION A, Reading (40) .

§ CAS MEAD TERTS OF ANY DIFFICULIV, OF & GENEMAL NATURE OF 1m FITTED F Aw AML Poe Atte, USING THE DICTIONARY

t owLy Rawtiy, -
FOAM FAMIT LAR STEIN, UEING THt

GATE GF grate

2.

Bs LANGUAGE

4 CAM READ TEXTS OF MOST GRADES OF DUFF ILL SY, OF A GIND HAL MATIUE OR fu BI EE AS

GICTIONARY OCCASIONALLY.
$ CAM MEAD TEXTS OF AVERAGE DIFFICULTY (fewapapern, roferance materiala, fe. Jr.USTNG THE DICTIONARY

PULQUENTLY, .
'

B CAN READ SIMPLE TENTS, SUCH AD STHELT Stes, NEWSPAPCR HEADLINES, rre.. UStuG THE DICTIONARY FREQUENTLY,

5- F HAVE MD READING AUILETY 5M FHF LANGUAGE,

SECTION 8. Writing (41)

THE DICTIONARY, 1 CAN
Ce AMMATIC‘L Ema, 1M

SIMIC AD GUSThe LAL WETM COMPLETE Surr has ap EGET USING

1 CAN WATE PrasoWaAL LETTERS and
Ve WRU PACTUAL ABH ALI VE EAP LE MOTE ESL TE CTA OA ECE RE Ee, ay te pee tp

MAUEVE STYLE, USTNG THE RICTIGNARY ONLY waAtLY,

WIENG PME DECTIONARY ONLY
CLAOETY, WITH bE GRAMMATICAL

By

1 FAN RITE PENDOMAL LETERRS Ate Siti Ame STUPLE MATER AL wT COuPAE TR enccesy,
. 7 PaHTLY, ' CAN, where TACTUAK WAUHATE LS BOG EsP OG tony ALE REAL Wi fie Edom eal TZ
£00085, GUT TA AR STYLE WHICH WAS MOT RE AStEat, UFiNG Int DICTICNAaY OCC ALIONALEY, -

: Te cadeenenaeneeneanianamaeemneinestetiadamemnmnemtnimnenmniemnmeenenemenedmnetienaammteel

1 CAM WATE PERSONAL LETTERS ANG SfwiLab SiM7Le MATERIAL, WITW AF ASSUABLE SUCLESS 16 CONVEYING MY MEANING,
. j BUT WETH OCCASIONAL MINGH GAAMMATICAL ZRA GSS AND BN GOVICUSLY FOALIGN, AWY GAD FTYLE, USING THE OICTIONARY

\ OCCASIONALLY,
‘ 1 CAN GRETE PEMSOYAL LEPTE AS AnD SEMIL ER TIYFLE HATEQPAL. @LTM REASONABLE SUCCESS Sh CONVEX ING UY MEANING,
Gt WaT MANY CHAMMATICAL LRBGHS ANG Sfp SB vOer FORERGN, AMR ARG STYLE, BLING Tod GICTIOnNsRY FAL CUENTLY,

(CANNOT @RETE IM tk LANGUAGE!

Promacintion (42)

: SECTION C,
: Se MY PRONUNCIATION ES WATIVES
‘ : . :

e 2 MILE MATUVES CAN DETECT Am ACCENT fy tre PECMUNC TATION Mtv HAVEL SS DIFFICULTY UASESSTAMDING ME,

G) WY PRONUNCIATION $3 Obviously FOmREGH, OT S5Ly RARELY Cash OFT Ca ty F929 HATEWEd TO GUGLASTANO.

UMCTATIOW US OCCASIONALLY DISK ICL FSR RATINGS TO LAB eK Pan,

+ 4.0 mY eae
¥ Ge to RAYE MG Seok IN PROMUN CEA CON,
. CONTIMLE OW REVERSE NUDE

voee ne Bade SECRET tacan:


14-0000

CONTINUATION OF FART It-LARGUAGE ELEMEATS

SECTION 0. Speaking (43)

PRACTICAL AND SOCIAL SITUATIONS! 4 CONVERSE FRECLY ANO HDTOMATICMLLY

1 A SPEAR FLUENTLY AND ACCURATFLY IN &
“UM ALG FOELOS wEte mwicH § am FAMILE

2. § SPEAR FLUENTLY AND ACCURATELY IN NEARLY ALL PRACTICAL ANO SOCIAL SITUATIONS: Ff CAN CONVERSE th MOST FEELOS
WITH WHICH 1 AM FAMILIAM AND fF EMPLOY SOME POPULAR SAYINGS, LITERARY GUOTATIONS, AND COMMON @ROVARDS.

a4 MANAcE TO GET ALONG 1% Ted MOST COMMON SITUATIONS OF DAILY LIFE AND TRAVEL,

SECTION €.  Unteratanding (44) .

BOTH FACE* TO: FACE AND ON THE TELEPHONE! 2 UNDERSTAND
PLAYS, AND LECTURES.

he J UNDERSTAND NON TECHNICAL CONVERSATION ON ALL SYQJICTS,
NEARLY EVERYTHING 1 NEAR ON FHL RADIO AND AT INE MOVIES,

1 UNDERSTAND NON" TECHNICAL CONVERSATION ON NEARLY ALL SUSJECTS, BOTH FACE*TO*-FACE AND ON THE TELEPMONT) I
2. UNCER STAND MOST OF WAT 1 WEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTUAES, INCLUDING MOST JONES AND

PUNS,

() t UNOERBTANO NEARLY ALL CONVERSATION ON TOPICS OF DAILY LIFE AND TRAVEL, BOTW FACE-TO-FACE ANO ON THE VERE:
PHONE) 1 UNDERSTAND MUCH OF WHAT F NEAN ON THE RADIO, AND AT THE MOVIES, PLAYS, AND LECTURKS,

BOTH FACE* TO*FACE ANO ON THE TELEPHONE! J UNDERSTAND SOME OF WHAT

AND LECTURES,

4. bE UNDERSTAND THE SIMPLEST CONVERSATION,
| HEAR OW THE RADIO AND AT THE MOVIES, PLAYS,

8, 1 AM NOT ADLS TO UNDERSTAND Tet SPOKEN LANGUAGE. .

BEFORE CONTINUING — CHECK PART tl TO ENSURE THAT YOU HAVE CIRCLED ONE HUMBER PER SECFIOR,

PART IUITEXPER TENCE AS TRANSLATOR OR INTERPRETER (45)

EMPERTENCE AS A FRANZLATOR,

YP oHAVE Hap

2 VOHAVE HAO EXPORTENCE AD AM INTERPACTER, oo

BOTH OF THE AROVE STATEMENTS APPLY,
aa soy

32.
(0) NOME OF THE ABUVE STATEML ES APPLY,

VP CEMTIFY THAT Int IHFOMMATICN GIVEN ABOVE 1S TRUE ANS ACCURATE TO THE BEET OF LY MNORLEOGE AND OFLIEF.
THES CERTEPICATION COMSEP TUTE S wy APPLILATION FOR A MAINTENANCE ABARD FAOVIOLD 1 4M ELIGIULE UNDER THz TERMS 06
bouuat@aramd Teal t MUST FasS AN OMSECTEVE CARGUAGE PudracieNcr TEST serune t
Fo€ BATE OF TESTING, ANNUAL MAINTENANCE AMARDS @bLa aE

REGULATION MOL 250015. Pam, ICTS).
BECOME ELEGINLE FON AN AwAHD, AND THAT DARE SPE CTENE oF
CUNRLATIVE AG OF THE AMALUEMSART CATE OF COMPLETING THIS FORM,

SPUN ATURE

CATE StGNEO

ee aie ard
fa drlote | jection, -*


14-0000

RLY on paneheelaatens Memes ate oo ARICA RNA LEAN RRIE NS SDM ie 7 I 02

Fee

ween

eee Ta

FORM WO.
nat 952

TEADLE Rs «127 Zens. 1252
Ay

-_ _

SECRET

Security Information °

raz #3, Charlotte

we : = i
Name: Last, First Middle
. Sse
ro

Qh: das " anddld

TO: . All C. 1. A. Personnel

milo - g-f -
FROM:. _ Persdnnel Director i
SUBJECT: PERSONNEL QUALIFICATION QUESTIONNAIRE

t
1, The Agency is currently revising the system for machine coding
employee qualifications, thereby permitting more complete and accurate
data on all personnel, The new system will aid in implementing Agency
policies on promotion from within by facilitating the selection of personnel
with desired education and experience tor vacancies which may occur. It
is also expected that the new system will provide readily accessible statistics

for planning and management purposes, .

2. The attached questionnaire is designed to.cover adequately those
factors in which the Agency is interested. Although the information is, in
a large rmeasure, already retlected in previous forms submitted by you, it
is felt that your time within the organization may enable you to emphasize
those qualifications pertinent to its needs. The questionnaire also serves
to bring your education and qualifications record up to date.

3. Your cooperation is requested in completing the. questionnaire as
thoroughly and accurately a3 possible and returning it to your Administrative
Officer within the tirne allotted. .

Mfrdlom,
wa

e'E, Meloon
C/ péfsonnel Director

SECRET :
Security Information
37-358 teeta


1400000

SECRET
; Security Information

_PERSONNEL QUALIFICATION QUESTIONNAIRE

1. Serial No. i (middle 3. Oltice

: no entry)
( y) GEHRIG , . Charlotte Luise FI

{

2 4, Date of Birth f 5. Sex: ___male Q Martial Status 4 6.CIA Entry Date:

i 12 Jan, 1929 x “x_femate (2) [ Nr. De pendentanae Aupint 1951 .
i 7. Citizenship: 8. Acquired By: (1) » Birth {2 Marriage (3 )__.Naturalization
t

i ; U.S. (ayo Other(specify)
: Other Year U.S. citizenship acquired, if not by birth

SEC. 1. EDUCATION
1, Extent: (circle one)
1, Less than high school 4. Two years college, or less 8. Masters degree
2. High school graduate 5. Over two years, no degree 9. Doctors degree
3. Trade, Business or © Bachelor degree
Commercial school 7. Post-graduate study
graduate (minimum 8 sem. hrs.)

2, College or Unive raits Study:

3. Tra eC, Ot NTO PEL » ane pee raed Ur hing:

we ote fest 15

Scheal

Miami Jacobs Muginsss tyoeiag and ehorthand

ers) [Tepe

: 4, Military or Intelligence Training (full time duty #4 a student in specialized
schools such as intelligence, communications, ordnance disposal, command &
staff, ete.) Attendance Dates» > .

_ School From | To" [Tot/mots Sty or Specialization

i
i

SECRET 1
Security Information a)

14-0000

recta eo een
’ Tet tee nna teem ma iyne she ernment tn emma

CE ae a a nee ee

se en A ne or IR RI

1 a) SECRET @
Security Information ,

SEC. Ul. WORK EXPERIENCE. :
CIA Experience: State the specific nature of duties performed with CIA and
CiG, starting with your prescnt position, Take position titles from your of-
ficial personnel papers, if you have personal copies, Please do not request
your Official Personnel Folder. Include geographic area and subject matter
dealt with, if applicable. Position Title is your classification title such as
Geographer, Intelligence Officer, etc, Duty Title indicates your organization
position such as ~- Section Chief, Branch Chief, Administrative Assistant, etc,
and is to be filled in only if different to the Position Title. Approximate dates
(month and year) are sufficient. Use a continuation sheet, if necessary, to
adequatel describe your duties.
Description of Duties: f haya ton reanacal htt by
Cf dinsert-ating aot rotting u)) renorts recived
from oa obotion, basa aperooriate action an

1,

78D
ranorts racalvad fron other apanetaa he Sarwandiof

tris inforratt ate the field ar donpl ine requosped
tata, I inform tha fletd o7 atditional info it
Maadquirtara on ts ysduale_a 7_organtsall na aa
requested or as daarcad -acevaary, ‘I alsa maintain

Duty Station, i: overseas: two CE notobooka, ‘

Description of Duties:
Same as above with a Gite fatlon.

PE/aH/P- rat

Office

sanee GPP i aor

Title:

Title: Ranortsa Of finer
eo
rom 33/71 To {2 Tot.ros. 3

rade § Salary 3/1006
Pi/dH/sraes,

T had leas

ffice
Position
Titles tos Ligaen 00% bege —_—_ _
Duty -

‘Tithe: feports Oretaer Duty Station, if overseas;

Fram Lisi) Te _fet.mas, 1 [Description of Duties:

aerate nerntere ene
As a casuih Yo tyeeead 4 Lays tet ss, renapanday

‘aowacn iT. 2 took

rade 9 Salary BUG an! dissaeminikiesn Tar
. a limthad uranak af shortracd,
Office rr/mftr _
Position
Title: | Seor-tary {Ubasorranny)
Duty
Title: Duty Station, if overseas:

Description of Duties:

Uishemt sated

ayn :
Se
Froma/“1 To Tot,.mses. 7

rooorts,

I nagam bled

n zs og aaryry
Grade 5. Salary 3¢M1I1.0

Office
Position .
Title: Seoretary (Stacneranky)

Duty Station, if overseas:
+ Y ussldy

wiiosevdar up Tiles

Vee montis in 4 .o pool ane. ding elatsan 2 3
SECRET {stax sania.

Security Information

|

16 apm. al pee, my

14-0000

.

;
!
a

SECRET

Security Information

SEC, I,
2.

WORK EXPERIENCE (CONT'D,)
Other than CIA: (Describe work experience for the last 15 years in sufficient

detail to perinit specific coding of your qualifications,

Include military work

experience, List last position first.)

| From /. "1 To 3/5 Tot.mo's /.

Chasi fication Gradc(if in Federal
Service) 3 3 ___ Salary 2265 703.07

Number and Class of Employees

Supervised: none
Employer Da artnent of Intertor

Kind of Business or organization...

‘(ive., paper products mfr, public
utilit

trom Li «ey To % Tot. mo's au
Clas sifinnie icat on ete if in Federal

Service) Salary (1.70 /or,

Number and Class of Employee

Supervised: 2 - 4

Employers caq fete

Kind of Business or organization

(i.é., paper products mfr, public
Marner vd UFO honne

From 2/59 _Tor/s Tot.mo's 7
Classification Grade(if in Federal

Salary 4200 / mo.

Service)
Number and Clase of Employees
Leena
Employer_; wedge tae of

Kind of pant inens ar organization
(i.e., paper products mfr, public
utility) trate ay tHoutakton

From iL fLLS 2 14 Tot.mo's.4
Classification Grade(if-in Federal -

Service) Salary

Number and Class of Employees

Supervised:
Employer petetdajen fro So, (er nn. tren, Va
Kind of Business or organization
(i.e., paper products mfr, public
utility)

From To Jot. mo's

Classification Grade(il in Federal

Sé¥vice) Salary

Number and Class of Employees

Supervised;
Employer

Kind of Business or organization

{i.e., paper products mfr, public
utility)

=) Security Information

{ Description of Duties:

Exact Tithe of your position
Statiattea? rifteman

Description of Duties:

T did mtatintical craftine, cartopranhy
Park{ag of (doertit fea J 6 aoe gy
- oy " wat ee tttony

Bop TN et cet oe,

Duty Station if overseas:
Exact Title of your position

Description of Duties: An ar atsistant to tha

axoentives Twas reepo sitts Par purchasing shoe
for tho pif t shopne aid teatrindt:
[ had © 3) -rasnonsiht ttt,
fo pate renorts an tha
biatrans ad acted as salos clears for tha shopna
Exact Title of your position
Agstohaut Bookkeaper

Description of Duties:
Imada month! y financial, rapourtn, had the

y hoaka, #22 k-ping and

rasporstutlite of the booka

q

vy clorks and

Peanhese ann! ava
of the haoba aid aanh,

ofiice wor:

Obnee Popa,

ation if overseas;

Duty
Exact Tithe of your position

Lovarzed ove month

Description of Duties:
storatory and

In the offica of the Chemfent
Live Hontus in tha fachorv,
15]. | ena

Duty Station if overseas:
Exact Tithe of your position

Duty Station if overseas

SECRET & 3

14-0000

a SECRET
@ Security Information @

SEC. Il. WORK EXPERIENCE (CONT'D)
3. Special Work Experience: Check any of the following organizations by which

you rnay have been employed.

01 U.S. Secret Service :. 24s Air Force A-2

02 Civil Police 25. Forcign Economic Admin.

03 Military Police | 26 Counter Intelligence Corps
04” US. Border Patrol 27” Immigration & Naturalization ;
05 _U.S. Narcotics Squad 28” Strategic Services Unit j
- 067 FBI 29 _Forcign Service, State Dept. §
a 07 Criminal Investigation Div. 30 Central Intelligence Group é
21 Office of Naval Intelligence 31” Armed Forces Security Agency ‘f
_. 22 Office of War Information 32. Coordinator of Information 4
23” Army G-2 33 Office of Facts & Figures Z
20___Office of Strategic Services 34___ Board of Economic Warfare :
3% Federal Communications Comm. H

SEC, 1], FOREIGN LANGUAGES
List below the foreign languages in which you have some competence.
include uncommon modern languages, Check ( X) your competence and how acquired,

COMPETENCE HOW ACQUIRED

Be sure to

CIA training)

‘LANGUAGE

Equivalent to
Native Fluency *

Native of

and written forrn (e.g., Arabic), explain your competence herein :

Lr AAn > den TEST SERRE Dla" icesnend haath mene ~ seem aay ES a LT a er a re Be
esSpecialized Languaye Competence: Describe ability to da specialized language work
involving vocabularies and terminology in the scientific, engineering, telecommuni-_

eations, and military fields. List the language with the type af speciality.

ae ECRET
Security Information 4

14-0000

, SEC, Vil, PROFESSIONAL AND ACADEMIC HONORS

SECRET
4 Security Information

\
SEC. IV. AREA KNOWLEDGE.
I, © List below any foreign countries or regions of which you have knowledge
gained as a result of residence, travel or study. Study can mean either —
academic study, or study of a foreign country resulting from an intelligence,

military, commercial or professional work assignment.
. Dates of - Manner in Which Knowledge

Residence, Study Was Aquired (check (X) one)

Etc. Travel
es es
es ee ae
es

Pd

Specialized Knowledge of Area

‘List specalized knowledge of foreign country such a3 knowledge of terrain,
‘coasts and harbors, utilities, railroads, industries, political parties, etc.,
gained as a result of study or work assignment. Include name of employer

Country or Region

or organization,

How and When Gained

SEC. V. TYPING AND STENOGRAPHIC SKILLS (PRESENT UTILIZATION)
Per Cent of Approximate {‘Prefer Assignment
Time Used Proficiency) Using Skill Oftener

Yes dix No

2

. Licenses: List any licenses or certi- ‘ Hobbies: List any hobbies such

fication such as teachers, pilot, marine, as satling, skiing, writing, or
other special qualifications.

etc.
painhine, sling

List any professional or acadernic associations or honorary societies in which
you hold membership.

@ SECRET
Security Information &

eet

nn ene


14-00000

SECRET
& Security Information &

SEC, VUI, PUBLICATIONS
List below the type of writing
general interest subjects, current events, etc; fiction: novels, .short stories, etc.)

of any published materials of which you were author or co-author.

SEC. IX. INVENTIONS
Describe any devices you have invented as to type of work for which intended

and whether patented. .

SEC. X. CIA TESTS
Describe below the type of tests which you have taken in CIA:

axamn for eanor ha ot ioar

SEC. XI. PHYSICAL HANDICAPS
List any physical handicaps you may have.

SEC. XI, OVERSEAS ASSIGNMENT

Are you willing ta accept periodic tour of duty ov rerseas?

| (i) 2 year Tour (2) 4 year “four G} Not ineerested

SEC. XUI. WORK ASSIGNMENT
In view of your total experience and education, iar what assignment in CIA do

you think you are best qualified ?

sat

feal Tan best cualtfied fer a ummerta oro rtszire peaition,

SECRET
Security Information

1

14-0009

Ay erecta eee

ST frtencn nara stan fever rarmnes emontgtin 98

FM ee ae mth tt eesan ee ee a eas

SECRET
Security lnfurmot’ on

SEC. XIV, MILITARY STATUS

1, Present Dratt Status
Have you registered under the Sclective Service Act of 1948? Yes No.

If yes, indicate your present draft classification

2. Present Reserve or National Guard Status
Do you now have Reserve or National Guard Status __Yes __No.
If yes, complete the-fottowing,
1. National Guard

2. Air National Guard
3.___— Active Reserve Status (member of organized unit)

4. Inactive Reserve Status

Service Grade Location

Reserve Unit with which currently aftillated

Service Mobilization Assignment, .if any

Location of. Service Records, if known

SEC, XV. CIA TRAINING .
ou have taken while in the CIA,

List the training courses or subjects .
Course oF Subject

2-1) Jor 1972

SEC. XVI. REMARKS .
Use this space to indicate any other qualifications you may haye which you do

not describe above,
pane np no me te

SIGNATURE, 442, ea2pr

DATE 18 Sentemder 1952
. a we

SECRET

@ Security Infornration Le)

14-0000

Bite aye

ne gn
i scr sevice cammssion “SLICATION FOR FEOERA. “MPLOYT

US CIV SEEVICE COMMISSION

INST RUC TIONS If antec te prevent delay ao . caneutoeationn c Tnetyrcticere on the afore cant reganing drqwwton of the appivetion
catia praner evere qreetun on thre forms clearly att coropiet ID yeu are apiteng Ge an UNWETT TAN eeaminaton, eras ths aprication
write oe pootin INK. be asisin Bad Dita Bintes © fe the ther nameatia the enncuss ment, Be sure hs mad te U\e pane office
elas Hien, rest the etaneraten aanounement cenrdalty aod tidlow alb anv ne fea ets pegurrest be the apvcuncement, Nett the etboe eth which

dreceune “tr yeu are epping for a WKIETEN eeaminaten, follow the mi Cite (his applicetem of ane change re vate eddones
RAME ww URAMINATION CR BING OF AIETION APRLITU TUR .

; DO KOT WRITE IN THES BLOCK
Fer Uso of Chel Servite Comeussica Only

your appl.

VGN OF mentioned 10 eteminetion announ
ae rn

TA STREET ANG ee Se AO ER

1401 = 16th St., N. W.
aT GY ca RST ORE FUineFadina saral Ty ne

Washi i
o pal 1B) HOM! } ‘

WRG Sr a and Sta

iit born outside U3 Sa

_ see Dayton, Ohlo rs
‘i

ha Ci wan it WAN RISet WEMOCT SOUS Wasi
aman bR5roUO

J be ee [5 reer Banca
14, ay HAVE YOU Evin BLIN femora By tue Feora, eovennmcaT? (7) ves EX) no

(2) TF SO, CINE LAST GRATE ANS CATE OF RAST CHANGE IN GRADE ’

INITIALS AND
OATE

(0) CHECK AF YO WILL ACCEPT APPOSNE MENT IF OFFERLO-
Yuu iM au not ha eonantored fer any poston with @ lower ontrance WN WASIGNETON, 1. C, a ANYAHERE IN THE UNTTO STATES:

eolarv. ; ne
10) CHECK IF YOU WALL ACCEPT SRORT-TERN APPOINTMENT UF CFFLACD, FOR (2 owrsne rit ence stares
D908 vont CJ s roe wontes 610 12 MONTHS #0 AP YOU WILL ATTLPT APPOUNTSIENT: IN CERTAIS LOCATIONS OMY, GIVE ACCEPTABLE

NOTH. Acvoptance op aefural of a tecoporary sare teen appaitenoat
will not alfect sour oppurruciey ta adtat a pradatwael appontnent

1. ” nnn 15 THE LOWEST ENTRANCE SALARY FOU WILL ACCEPTE 8 00.00. cee eaeenee

GE) HOG AGL WILLING TA TRL SET CI

j

16 Pepediae Tt we dauparant Feo yen Gey Gurnish ait information requested religions, elo, Gelfice ap organs
fetew In adiient deta te cmable the Gav derece Cammission nad the einer with oe withwut comprogation, aimwing the aumaber oF hours pes avecit
apgenabig elt va ad wee Sola gree ve fall cre tat va determing yas ABE weeks per yaa EA wa yo wee Cngaged fa een, wity, OM ary
Qe dications Ure oi ack Me Ue fare Beart with tewe  eapentenee shoud Se deacnged en gis apacey Letowy in Ha BS FALE

poatian, Sar
present wk ona, taninta na . the Ufaipel tessa sith fa) Ef you mere seer emys oval ot aay penton ater a aay rent tone
yee perf AQ os stabi ¢, A is thar cheesy Gea Sita apphoaran give wine Dena oa of year
ie qr pravea, inent to thy work [RSS Sutea oe eae the dacitasan = a 3
ents ot ihe ble ke we PAE Pew rane sae -

“actly ehad war deve perronmted,

for wines yeu are apphang mar De sue |
Uf your duticn changes matnally whith werking for the aame einpleyer, uae (O) Hf yon Rave ewe Bern cobead op are now uaeenteral, dadicare J
@separste bak ty verents cak petio, bad ney tadade doy pertinent Uhat fact in the space srownded bets ic “Prescot Pasta,”

Peet

PRESENT POSITION
EF UML) Ban’ Torn  veaey OT TTY a cP TTA or very purine pone’ 07 CL AFCA TOR EAE a
vr Folornt Seeenos STARTINS, SE8p_ aye

¢ [ee TBS

__ Statistical P Draftsman

AMG AM THLE Are SPURNS

Meg, Mildred Voorman

Til Pedoral, | WAR OF Bose Se Ot CRLAAEATION GS og) w Melonate arta
sere divine suntufectusa of loses, ate ) + ‘

PRESENT, §

Peep M Es
“Washington, D, C,

“REOE Ana kere Ge ne ed (aria,
name dopa foend, dtm oF eth

Board op ogeenent teal Names 29,

AA om EMPLOI

BRO Oe CUM ONES eed OLD Be NO”

REE Sa teh

OTE nn we ner tte ct tiene eet ee petro

WON Ur rot

statistical. di
typing see
marking dlacritdes oo

YT PAGE)


14-0000

We CONTINED ~

) OATES OF IWR CI wast (tonsa, zeae) TT eased 1708 OF Yous rosttos ] Bau TON Sea) Lae OF Lines
warnms 100 an hr

| {ef tn Federat sary)

meu «5/50 3/52 Bookkeeper-CLork
Paes OF GBAOVERNT (ote sed Stier wiuy ake TE agro aeeeg Mt AA Oa
Mr. Ray F. McXechaie

Dayton, Chio
RAGE ANS QSCETSS OF ENR OUTS Crm wianivetwon, or pormn, of Pedoral, | Kini OF DAMES 2 AGAMIATION Ue @. wholesste wth, Inowteme ofoicy. |
name depercovent, berveu of ortebinenment, end dryiswn) mranulactare ef labs, ore)

San Rae Garcens, B, #, 11 Dayton 9, Ohio Nursery and Gift Shoppe
a yc 177)

WOUDER INS UND OF EMAGHES BUAta SES BF YON
New Job

2 - 6 clerks

mampeb tetas aoe

nes aeneenecanscsssaseesaneassnonasd

ga Loses sosenegnneseeatvonesetsnssstsesssvennesnomannage sinus

| ------Made_resork 9. forthe. execut, ive oi. the. buekitsis Zinafona, eben

33

CATIS OF LWA CTARAT (month, yeas) PRACT TITLE OF TOUR POT TiN i CABSSERATION CORY SALARS CA ssn
i wervacw)! srattring 5
om: B50 9, 5/30 ___t bat. Pokies eper__/ Li
FACE OF EAMOUMENT qusty and Sta AnD Sina a ii Tad ULDA TE SUPREME
Mr, S4iitan F, Seale

FIND OF wuss Ce UNGAR LATION Oo da, Fre alk, fe agama
Manulactura tf kuths, ata)

sampashington, D.C,
FAME BAD ASIA OF WATS UAren erganinetiony ar poreant It Kederel
name dapariment, bereau cs eatsbLenaent, and drearan)

National Peanut Yourcil
mont Cirele. #1dg._Nashington,_! CC, ss Trade Assoctation

NUMBER AND RIND CF Roos Series ef sus REASON FA LEA vENS

cere HONS
DESCRIPTION of Ww Ley a

FTN eee reall ite tet Caner oon maneneaggen eg ee

ee _ ere taper put emer ee
Tat Hid UF POR RAIDEN “ SAGE” Po pecae? Of bakers,

N) RATES oF BARS ONT tomer ts, peas) I
4 i, | we za Keteredoerete) yrasring 6 rep
feb wr BY? Benes pe
Pla GF UASTEENE ary at rey Varid tae pe rica Te | SR ee
Dag | Mp. Herbert Hauldormin Per
RauE WS ate (gatlnteed, ge person, iF Voderal [HRB Go Gave Shia
Rate dapart fahata it ated Are secon} nan sat ete j

Fricsisive, Flant 2 Savten 9, G Manuf. of ‘rtpidstrea
We ae ~ ~ —
| return to callese

VS aes & rianctag *

TRYDEER ARO pe
none

“GESSeip TON CF Sn eae


14-0000

:
:
}

OrScUPTON ce YOce wun

2 eee, Seiad a a
th, pear) TRACT TAL OF MNT TR “" [ag PROM GRATE SALARY 8 EARMINGN
Ulin afeervice) | STARTING §

FInd, t eo

DATES OF Ow CUES

yRow 0
MAuE @ > | a jwutuians EUrLAVISOA

PLACE OF THRCIEST? featy and State)

RIND OF BUSINESS G® ORGANIZATION loa. whoiesals elk, wneurance agency,
manularture of locbs, ofa.)

MAME ANG ADORLSS OF EY THER (Bert, or ganiration, oe
Name dopert cea, duraau oF establiahment, and

MUMGER AXD BIND GF EMTLOYELS SUPLAVISCD BY YOU REASON FOR taavina

sesame ememnenmenenssentes seas senatoronmraneanseeacsretesstmeeeebarntenegesanets wen eneennnemmenTetS MEE CSrErsesenccunwennes Ren emeeT carn etbeerenebene en enen sn mnt Neeet manne:

de eee emen tment eee es cate Peeeeememngteenmgeneenseenane RoneEpEaeeeaneEne: Mun ttennNtnMmnRMSnReeeEZEDs neers tEDEs Demanamebrnnnecetensts ne nunannmenenenn tastes MORGaaaneeses

es more evece aurehne use a continuation sheet (ramient For Noa Mara oy of payer the ene ise as thie page. Witte oe each edeet your name,
adilreea, date 2 teeth, aed esamination titie. Attach to ineule of the arpootwa,

u. MiTaRy TRUNNG fa the epace Below, descsihe any training reseed ta of traioing fertiye), each ae hours per week. Detaded information
Sermcee (oot alieady Leted under Item 14) that woukl aseet ing any specie! eazvice echools you attroded ie especially important. (|

appointing oft re i nig you most sflecuively,  ladicat ual_ amount pegre may be ueet pre full deecriptions,
"DESCRIPTION OF TRURING-

petiad

at LocaTion
From | Oe ee mee nema eeneneeen

$8 ECUCAIION (Cirule Arghoat grade completed 1A GIVE ANZ AND LOCATHS OF LOOT HIGH SCHOOL ATTENDED

yok d & 5S 6 Fy 6 8 RT

TOS VICTS STUDIED IF NOM BONO WHICH APPLY TO. POTION DESIRED

BARN QQ Tel APPROPUATE BON TO INDICATE SATIAFACTORY COMPLETION OF

t Gaeewage re = aiaal eres. OFS 74) ei Bore Domes Y
wajoe pares ATTANOED i i
(2) HAMEASD (QOATOON OF CONLEGT G8 Ue ERSTE aN seme emer | mene 5 nee - Poona
SPICALTY j a tee MONT ae | |. emcnt

AO din | BA. {b=50 |S.
SLE. 5
- 122-50.

LIV 1G10 Sh8F Gis DATE COLLIGE SUBIECTS

Tj] Baette
PRAY

ioe

“LApsResabe ‘Boybonaet oi % ~_a

fy OTHIM tear AL AUBNEAS, STIS COURSES
as SHIGEe (show fame and haat
“USAR UCE Tarai 19 PUALIC OF PRIVATE CUPLOT MENT

sO MEMCEL AP AYT TRAE OR Pity
SUR UN eA ae piled ghee trrcian, 14510 Operator, baa Aor, aryor, CRA, ata HF

tO cree PRA ANS Se segnea ow js bisneinith
POHEG NE LAM hoa

= on .
ly vas OES tei Gret AIne 2 LICENSE AND STATE.

PGE Lice WEE OR CLUTIMEATE Gs dang

French
DDE, ONE TRAST DRO IN ANT FITC T A Fa ENTS ne Tene CENA OH CRA CAD Cerboy .
PP RUE OD RES et GUAIKA AMD LET So Med Sern PE ee a on rmranrenranrern tarntnenc

2D Be ND SAE AL gee tee OT CONT RTD LEE AE SEY TOR APPLICA EIGN SOON AS

GRAB AVA MR Le gy MUSE barr Ne, Lusinets,
(ES a EE I Aras bo a NONS (do not sedaid cone Unie fegnna led)

tren, eovreatcwss
, - Oe ESE Ck at

Guatemala hi Bn8/48 Eduaaticn GDS ee ANE se EDT OCPEMENCE
* Se ong west Thee MO ATRL US OF ENS SUCHTIES, ATC,

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me paare

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FOR AD Pb

as Lsth ate Cater tet
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SA BN

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ARE TERE, ORE Oe wb La REET E REY EAD by
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&
on

14-0000

i

ng in the United Staves on Tae

PA REPEC E Leet three perees
Piatt sails atime and fines ter the po

FULL aM +

rat

I.
Yr, John Lewis Oskwet Hizh Scheel, Dayton 9, 9

Cazanovia

Miss Treadosia Horan - - >

Mr. Verry Schwartz
—TaoieaTe "TES" CR CHO’ AmSwOa OF Fitna ” T provi Cowan ls a

TS WAY sey sOF OF MATE OF TOUR PELTENE §MPLOTEA REGARDING YOUR
CHSPACTED Quatinicstigms FTTH,

a ne A Aen wena evan
m fee ORS A CITIEEM OF OF LO TOU Owe ALLEGIANCE ro THE UNITEO | °°
Seve se SaeeTanreran bated

27 APE VOU tye OR WAVE VOU,F VES CTEM A M2 MOEA OF THE CoMMUNEST
PARTY GA OP AMY COMMUNIST ORGANIZATIONS ~

28 AST YOU HOW, OF HAVE YOU fvts OTL A MEMOER OF A FASCIST O8GAN.
traTscny :

DO ARE YG here OR HAE VOU EGP SOE 8 Mt MADER OF ANY ORGANI ATION
IAT WIE MENS GOCE Cm CW RIAATICN OF PERSONS WHILH AD

YOCATES THE (Te RTH POVE OF OUP CONSTITUTIONAL TORM OF GOVERNMENT,
GROAN OP ANITATION, ASSOCIR TIA MOVEMENT, GROUP OR CUMMINATION
OF PELs, MMA ADOPTS Te & MIE COP AUVOCATING OM APPROVING
THO LOMAS IOR IE ACES OF FORCE OR OLENCE 10 OE NY OTHER PF ASO
THREE PHT NTA RTE CONS TET TION OF PE UNMET ITAL SOR OF SET te
WWE TO BLT Taf FORM OF A PAE GF THE UNITES STATES BY UNCON

2 isTirMay Ui sted

a jou. anewor ts guestian 27, 24, 10 29 ahova fe '’y:
mye

Ot corbhinatta persone and datos of
mambarrship complnta detaite nd pote ecrieitias
therein ant make any planation you desire regarding i
nut membhaschip on activities therein

WD BINGE 168,01 ETH BIRTHDAY, A dE ‘CO PCR BELA ARRESTED, IN(ECTIO 3

OO REMC MTG COURT AD RAPT A DAAT INA CRUMINAL PAOCED DING

OM CLAG 10D, FIRED GR IMPRIV 48 D Cf FLACED O% PROBATION OM 14k

JOUR LB DEEN Git It TO TABOSE BAH, OF COLLATORAL FOR TUE VIO AL z

LG BAY 160 POASCE REGULATION OM ONDINANCE EXCLUDING METOR i
i
e
H
5

x

TRSESIC VILLA TINS POR WIE A rms OF FORIEICUNE OF 29 CR LES? WAS

Urea
If your anawos te wich cases under Hem 39

Ye
batuw, Geen ineah case (hj the date, (2) tha natues of tha
attense on riainton, (3) ta Gama and looattan of the court,
{4) the parnatty im af aay, ar atiar cipoattian of the

cace EM apyonuted, your Nngergeente will be inhon
pe een Ses entnnn samuemn a etme | atm

PET COTE peat be
OT OR UNSATILF RE Hae - AM POSITION
YW your aiswer fa Vee! geee in ftom 39 the nama’

addreace of amplayer, data, Ares peregn in Bagh cane
Wee eG Fete BETA MAUELD BE FEE G Chel LACE COMMS on
PROTA TAGE NSE ATING GU ALO ERE CUTE SERSICE REN RNTME OS
U your anawet iy Yer" gery daice of and reawas for |
j-auch dahasinast tr free 19 :
BD HAVE 10 AWE PIOUCAL MAGICA CISTALE, OR OTUTR DISABHITY
BOLE Gait BE COMUEE AEG Ms SEGtGMIBG YOU TU HORA. a
yours ) give conipleto souniein trea dh aa |
thet conrdsteral-on can be given tO your physical fitnera far

the sob,

steak Cry Cal RR!

a

GY (LU MBIA SOD UM Tae SAME ROTIAEMCHT ACT Jit ANY
OF UIMER COUE NSAP roa Mist hie CF Ravat CoNew fh,
U gous anewer iy Yas," grea vonipietn setaite in Lom 39

) GALE OK (Afeulp pi aths te GY

fr

wien fe which vou are sapiens fer eet
7
Orre compere cyssant

Andee ren ned nn seeneenennanseesene, sreeaeeeraanugnenae-|+nsenencuearane

Univ. of Syracuse, Syracuse, N, x

loko Gandug ia tient furans >

sap wed tie Untied Grates who are BOT rotated te vou and wha have itesove enowledge of

al ooneaal toperyreda hated unter Item 16 (RAPE RIRNCRD

seal adSieoa tp td etree! BytINER CA OCCUFATION

Principal

as) Ane nseeRnancantecsinesscssen nos sreetsseupenrenns.[amrererarere bees

k, D, 2, N.Y, Teacher

Professor

vis ‘0

+ INQICATE “VES OM WO” aNtwhE aT Mating “1 it PROPER cchumN

Yh ABT YOU AN OBPICIAL OR EMPLO IEE OF ANY STATE, TCARITOAY, COUNTY
(@ BUNICIPALITYY sateeeensnsane x
df yout answer fo YN

BUS THE UNITED STAYS S 9/1 HUMENT FUPLOY IN A CIVILIAN CAPACITY
BRE RELATIVE OF YOURS (AY BLUGO OF MARRIAGE? WITH WHOM YOU LIVE x
A MALE LIVED WITHIN THE PATE La MONT HOE

i) your anawee ta 'Y
salative (2) fall name;
Depa: for A
MAT ONE

SPECIAL INSTRUCTIONS FOR CLAIMING VETERAN PREFERENCE

A. If you are claiming preference ae @ PRACRTIME VETRRAN who hes
tern warded | a ceinpmagn belge cae eoribien, of a @ DISAHLED VET.
MAN, eo WIPE OF A DISA. VETERAN, of os the WIDOW OF
Z_ WAR OR CAMUAIGH VRTRHAN, attath Veturan. Preterence Claim,

CSC Form 14, Cogether with great qpecifiet therein,
B. Uf you ate a WAR-TIME VITREAN not claiming diaability preference

oar aiuuld NOT submit your diechasge with this application, Preference wilt
Urntatively ctedited ta grat end Wo egganted, you will be ewquleat to submit
to Um appointing OMcer pel ty entry on duty, offeial evidence of separa:

hea fron active service in the wrmed forces of the Uncted States lo tine of wat,
1 43 nO

27 th) WERE YOU CVER tM THE UTED STATES MILITARY OF AVAL Stance
IASUNG TIME OF WARD ....., =
1B) 1S THE WORD HONGRABTE” OR FHE WORD “SATIAFACTORY * UtEO
1H YOUR CIDCUARGRK OF SI PARATION FAPLAS TO SHOW THE TYPE OF YOUR
PLMARGE OR SEPARATIOND oo csacenes
AC) WAS LUHVICE PERFORMED OF AN ACTIVE PLLL SIME aeais wire rae

MILITARY PAY AND ALQOWAUT EST
1D | DATE OF ENUHY OR LHTRILG HT LERTCE | Ontt OF SerARaTION on SUFARATIONS

BEING OF TERME Chr iny, Navy, | STAAL Ul none, five grado oF
Marine Carpa, Coaat Guar, et.) i fatiog at tiene cf separation).

ore ir ar
|

TMP CITE STATES MILITAR COO NASAL RMIT
CTO RTE REE A OR ORION OR EE

URN RECEIVE A CAMPAILN BALL OM LER UI e RIBOONT cee

1 yams

ARE YOU A DISARITO Viti Msn? .,
Maa, and you have ant listed your dleabihiy in answer ta to
fteut 33, anpinin ya Lizn JS below |

GD ABE YOU A VETER AHS Witaye fat) MAD NOT BE APA, _ _—

NMED thd & Cede L CONNECTED | i
Poste MTA darts ES PINT

WIFE Oh A tee Tai.
JACEE HEB S

PO ARE TOU TH!
Uae RUT wre fe

THIS SPACE FOR USE OF APPOINTING OFFICER ONLY
‘The information .entained ta the answers to Questiem 37 otpwe has been veel
19

hed hy comparison with the dlteharge certificate ua...

peony:
SF aRSeaT ET

i e oe eG.

fe WW edyuitet, une paper the yas toda on Pale wee

ef thse agtsea?:
Before segning Chia apy
TCURTIFY chat the ara

and Selif, and arc made ut gonad Faith. .
False statement on this application . og es ty
is pasahanl« by Law (UL 4 Cote, ss NGNATUSE Fen CANT
Tatts 24, Section Ao) pew Mak

re

OR Gener mam eae

ation cheek back ver Poba wisee care Unst 5
iements male by mein thie sppice: ton are true, complete, emt correct toa the best af my kogwiedse

wohave anwwered ALL guestiand correct!

hale, aod og’ourcat Hf feruate,
g ren same getty Atay bo haw)

acue IMR G
heb 4 eng TAD Tae Pee ian

Ve beeen t


ON te te oa neue a coe ERENCE Se Lemme nene somerset 9 were TO tersvernais an ere

: Ae op 5 Ky Wst, Scbjuls
Wath gon addr 3 ‘
7 FEC? Davis place pw
: [hor ~ ORdlucy «IE

14-0000

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Ter mene tte nets ok ean maleic Aly Mn epinee mae alae tn anne cm en iin Gon rasta,
ire oe a ed? Accent

TON NE ne leans ion eee atm ee

PERSONAL HISTORY STATEMENT

Instructions: 1. Anyrer al} questions completely. If question {s not applicable write “NA.”. Write
“onksren” only if you do not know the anawer and cannot obtain the answer from

perennial records, Use the blank pages at the end of this form for extra details on
any question or questions for which you do not have ‘sufficient room.

2. Type, print, or write carefully ; illegible or incomplete forms will not receive consid-

eration.
HAVE YOU BEAD AND DO YOU UNDERSTAND THE INSTRUCTIONS? __...Y@S_
Bec. 1. PERSONAL BACKGROUND : :
Telephone: .
Mixs . Office ... RE..1820.
A PULL NAMS 35%... Charlot te. -Loulaa seets panes Zehrung... Ext...
Um Mo aed (Hid Mister (any |
Faszass) - : Home
PRESENT ALUREAS .... ASQ AGH. Stayt i. Mashtngton, De Cy eevee USA......
. (50. and Number} (ity). - (Country) .
PEBMANS ST AULEESR San. Raa. Gardena ,bayton..9,. Ohio. RR.-11..... sanees
(St. and Number) ta bo Us
B.NICKNAME Bherrh WHAT OTHER NAMES HAVE YOU USED? ... ngng---—-----—

© enone nonrenenesemeneerecremee UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USED THESE

HOW LONG? 0 ES Ip A LEGAL CHANGE, GIVE PARTICULARS ccccccscnece cecneeceeuee cnc

G. DATE C¥ MIRTH. 1/2/29 — PLACE OF BIRTH 2.20 DO YEON. OKO cone USA .
{C1 (Stated tannery)

7. PRESEN Cneevene USA WY BIRTH FOR... BY MARRIAGET not

Country}

BY NATURALUATION CERTIFICATE NO. .1Q.0.. 2 ISSUED oo. cee BY nee eee eeeeeeeeeeee
(Dated qcuun)

(Country

HAVE YOU AAG A PREVIOUS NATIONALITY? _.... PONE
T¥ea cr Na. t

HELD BETHSEN WHAT DATES? TO we ANY OTHER NATIONALITY? .. sceeetenee ce

“Weantey)

GIVE PARPICULARS lo ecu cmences mneesmen ect races eneernerenmnye ees sa snavptoanensecee tase conssncaqecd cceerese

GIVE PARTICULARS:

HAVE YOU TASES STEPS TO CHANGE PRESENT CITIZENSHIP? TQ |

re tant 38- H


14-0000

: 4a) ; ¢
! E. UF HORN OUTSIDE U. S. WHEN DID YUU FIRST ARRIVE IN THIS COUNTRY? _. aeeee nenee seerre ees cadebe oe

PORT OF ENTRY? |... ON PASSPORT OF WHAT COUNTRY? 00.2. eee eccmerenecer ee

Seinen mebaang teens He de sev

1

iq

3 LAST U. & VIBA ....... :

. aType? (Piste of leave)
————— ee poner hge a

Sec. 2. PHYSICAL DESCRIPTION

ace 7? sex Peron 52 8" werent 225

(Date of Issue)
se . a scouts

bl: ‘
36 warn PM comprexton Bede scars.00n@.

. slender :
BUILD «00. -semeennsernerone-» OTHER DISTINGUISHING FEATURES ——_-____—-_—_—__---- =

— - 2

, spose

, Sec. 3. MARITAL STATUS

A. SINGLE meee esses MARRIED _._. DIVORCED _.W0..samennmee noes WIDOWED

B. WIFE OR HUSBAND (IF YOU HAVE BEEN MARRIED MORE THAN ONCE—INCLUDING ANNUL-
MENTS-~USEH A BEPARATE SHEET FOR FORMER WIFE OR HUSBAND GIVING DATA REQUIRED
BELOW FOR ALL, PREVIOUS MARRIAGES) . . .

NAME OF SPOUSE ccc ecco sccescsceeeeceseceeeeececnee eee toeerenne senses
(First) iMbidde)

PLACE ANU DATE OF MARRIAGE |. eee ence eee ter eee erence ner preteen teeter eee asec

HIS (Ui HEH? ADTRESS BEFORE MARRIAGE

Use nd Havabery CER YO Rated

LIVING OF DECLASED oo eee DATE GF DECHASE wee ee

PRESUNT; GR LAST, ADDRESS oo. ceaecea tanta renee

(St. sad Nucoberd (Country)

ety
DATE OF BIRTH oe PEACE OF BIRTH 222. ees ce cceeceepeecran ve erent ee weeny cates
(Cie? “ {Stare} (Country)

_ ITF BORN GUTSINE UL S.INDICATE DATE AND PLACE OP ENTE

-. WHERE?

CITIZENSHIP ...

. WHEN ACQUIRED? _.

: OCCUVATION oo een eres LAST EMPLOYER 2. e cercnecceseeen ee mnebegeneceme

EMPLOYER'S OR BUSINESS ADDRESS .... sete gee sence nee amanen ee ce seenaaeae sence csemene ssa cene snes scones vee creer see
. aed Number) iCitz) Ghat (Country)
MILITARY SERVICE FROM 020. ——2 TO ow. BRANCIOGF SERVICE cevecssmecevesnseedls

iDaste) (Bate)

COUNTRY 2. nee ceecen teen ces DETAILS OF OTHER GOVT. SERVICE, U. S°CR FOREIGN

toss met

a) . oS


14-0000

anne: SY
. Sxc. 4. CHILDREN OR DEPENDENTS (Include partial dependents): none
i Lo NAME ete eceeee tect eneeetenace RELATIONSHIP oc negeoneecneeens ee AGE ene
CITIZENSHIP |... panemeenitee ADDRESS oes eecemen stay "ay nen oo

2. NAME W..cvecocecnn-csorennee: tea nant gntnonneroeteanes sevecesneceane RELATIONSHIP 1. -ncoaecncsnnsneremees AGE assem sceten

CITIZENSHIP .....n-ssmecnceneestaneseeey ADDRESS Be aed Namba GT
je ond Number) city)

3, NAME _ wae RELATIONSHIP 00... -epesesconeecseeence AGE -oaeeseeee

CITIZENSHIP. .... -on--seereceensserensooenne ADDRESS ........... : oon shoas steveomscncrusatecenstiessusaecs
- (SU and | Namier) (City) [Stated 4 y .
ER I I TE sa iiaeiiniiiamdeaimeindsiateadiiaiinaimiemmmnainaammme tana

Sec. 5. FATHER (Give the same information for stepfather and/or guardian on a separate shect)

FULL NAME ........c28rU0l | Penford .. Sehrung.

one (Migdied (Laety

LIVING OR DECEASED ..... 2AVINZ DATE OF DECEASE oe CAUSE weccsescnernrsseeee

PRESENT, OR LAST, ADDRESS wet ehatense rena tten ee bene tears nent Meces ter Mente conmrve tebe cnnnvenetanenseeneneg n enve ns ee -
iiiates ( Country}

(St and Neiniwep (City)

Roseville, Ohio USA —

pare or mney 2/23/2892 prace or ammri ....22 By Onto |
{city} “(Bastsy "(eountry)

niet daateeaneeeaimmmemmetnernel es eee meee i ne aT MES

TR HORN OGTSIDE TO SOINTICATER DAT AND PLACE OP ENTRY 20.0.0 oo ee eee

jg 5
CITIZENSINP mails WHEN ACQUIRED? _... birth cence WHERE? i
: ty

thst nxeroyvnr O87 Sxployer ~ over PO yea.

8 U SA

Statey 7 (Gonatry)

ome tiger

ocourartone®

EMPLOYER'S OR OWN BUSINESS ADDRESS ..

MILITARY SERVICE FROM ..-.2070.. TO. ceca ae . BRANCIL OF SERVICE, oo. eeesee in eects cneee :
Date . ;

COUNTRY 0. eee ee) DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN

+

1

!

| (Patey
t

i

i

t

Sec. 6. MOTHER (Give the same information for stepmother ona separate sheet)

cooky

_ Hazel Charlotte. Jackson, _.. 2ehnrng

Thin” ‘

LIVING OR DECRASED Tiving..... DATE OF GEUCCASE oo CAUBE oo .- ee

FULL NAME...

PRESYNY, OR LAST, ADDRESS _ San Reg, Gardens; i dayton-04..Onio—--,,USA.

Cage! tteantry)
pate or nintHto/27/1896 pace op wintry Montasue, Michigan USA
errizensurp USA) wHeN acauIneD? Darth. were... bog ceeeeeee ves coves

iCity) ytiatel tUeantry?

IF BORN OUTSIDE U. 3. INDICATE DATR AND PLACE OF ENTRY 00 20 n- eens

‘

@) 19 --eRens


14-0000

nena

21 om renee ere ee tenerpene meine eet CS LLAehanetle kink che mdy os mete en ae

rea

Seah Sie

Ae erctrin alesnvbet AUR aE oR

ay,

(4)

occuration ..boUsewi fe Last EMPLOYER Detroit Bovrd of Education

EMPLOYER'S OR OWN BUSINESS ADDRESS .

ano" To

MILITARY SERVICE FROM ...uLTIT_..

SEc. 7. BROTHERS AND SISTERS (Including half-, step-, and adupted brothers and sisters) ¢

L FULL NAME --—_dlangy. eos SNOT 1.) oj) 0s]: Sa ann “isa ACE BL... ne

(F iret (Middle)
Verity Hall rladletown Hospital,liddletown, Ohio
. , coum no BSA

(aig pad Nu SE Won ~~ Getate i ona ( 7

BR FULL NAME, .on. ec ceccac cee cee eens seceee tn eennicee as sunenocenee nee gennaceseve nsens adie neers snpnecmmenentiea snegneinees
Urine (Mickle? (haat)

San Rae Gardens, Dayton 9, Ohio USA
(8H ond Nuratwe) (City) Citatey” (Counter) .

Mary. _Flizabeth Zenrang....

3 FULL NAME .u....0.6 teed ecraeemnnenee vee senna
(First) “(alain ©

USA

PRESENT ADDRESS ..

PRESENT ADDRESS ..

PRESENT ADDK ESS “

“itated “Wountey)

eo

“(ai and Number)

4 FULL NAME .... 0. sete eeenestinecrewane satin setenatee nies satsece cermee tise seeesenemecmene einen ee
(Bint) ” (Middle) “Gian

PRESENT ADDRESS . ctewense errs scaem ener eretwecercencerewereeeet tenes tev srtney san naP eee eetancares hesbadnanenee
“ae ‘and ‘Nomber) . (city) (tate) (Country? Withenshipy
AGE wee ee

Ce ES |
(Fiant) (MN ididte) . . (laat)

PRESENT ADDRESS 2 oe ce eee ec tccee e cce rece eens te sosceenemsanenna coagaeace san igteneteeeete
OM, nad Nuahery Hyd {Htate) {Couetev) Prat inne St >

soe get cntenrtgty teases

SEE gee cee

Sec. 8. PATILER-IN-LAW

FULL NAME cece cece ene ceeee renee ce neree ne eeeaecee can saeaneeseeaa seas seagacenee tees santo aecaseneeeceneseen te
“(Fiest) > eBay . taney

LIVING OR DECEASED .. 0. 1... DATE OF DECBABE oo ee CAUSE ern enene

PRESENT, OR LAST, ADDRESS «4... sateen ceeneepeneceuen caw eeeetens tenteceenteee

“(se Gad Number) (ity (State)

DATE OF BIRTH _..

-. PLACE OF RIRTH —..

TY BORN OUTSIDE U.S INDICATE DATE AND PLACE GF ENTRY .o..cccsece ee et aeeweaee ,

CITIZENSHIP oo WHEN ACQUIRED? 000 00. WHERET Oo

(City)  vewater)

“ QCCUPATION 2 ee ce eee LAST EMPLOYER 20000 e cette oe


14-0000

it a nt ee tee etn ae

Sec. 9. MOTHER-IN-LAW
PULL NAME ou. .nn.... cscs resneenecenenmccueenenenmnntetaneecteesticantee sau seusensenaneuaeseeaencanscaeezsseenensanansentenrscseacenen
ri) Chast)

ia

Shem Ba atten EY Pe FS TAO LEN

LIVING OR DECEASED .....,... 200-0... » DATE OF DECKASE ..........--.. CAUSE cocci eneeeee

PRESENT, OR LAST, ADDRESS ..... vescnunmeeeepeensvuneensaevetssngaeasunsecnuecetuenscsaosesausesasesstseseteanessonuenes
Sw. and Nemter} (City) qState) (Oountey)

DATE OF BIRTH wu. nsecsesnne esos PLACE OF BIRTH 2 o..cccccecceceens ewececeunenemessmanatecnsnsanasesnecomensmane

IF BORN OUTSIDE U. 8. INDICATE DATE AND PLACE OF ENTRY essere stteeanenintessnsectesanincenens

CITIZENSHIP o.....cesesrseeee WHEN ACQUIRED? occa cence WHERE? vec. econ nies cammgetecgencens
(City) (Stato)’ = (Country)

OCCUPATION ou sccceeecestereee rene LAST EMPLOYER ..

peers CUPATION a snnermnctcrsnrsct RE DEES IP at TTT SANCEIS a TY FS unre 7
See, 10. RELATIVES BY BLOOD, MARRIAGE OR ADOPTION, WHO EITHER LIVE ‘ABROAD
OR WHO ARE NOT CITIZENS OF THE UNITED STATES:

1. NAME COl,Paul 2ehrung oo ReLationsiip.co8sin AGE ...38.

HI_USA_WE, APO 633 Post waster
{St and Number) qcuy) eae (Countiy)

2NAmMe Gistont relatives in Svedemecarionsinp eX Bets

Grandparents on kother's side cauo from Sweden _
CITIZENSHIP ecco cccseteeceuee eee ADDRESS ee .
: iCointey

(St and Nutahes) tity} (tater,

B. NAME co escerce seer reeieetsustes permeates renesemenmne RELATIONSIUP veces oo AGE cece

CITIZENSHIP 0. neseccew ree cesecenereeces ADDRESS .

seer ewes coal taints anette Rhee bton nom ne
a
&
>

ADDRESS ...

CUTTARNSHEPR 0 eee
2 SS EL a ES Sa Ss I

Seo, 11. RELATIVES BY RLOGD OR MARRIAGE IN THE MILITARY OR CIVIL SERVICKE OF
THE U.S.OR OF A FOREIGN GOVERNMENT:

L NAME, cent ctetennenens swan stseressarrneersnesseasret anes assess say a vene ees estanes

EL USA #6, APO 633 %Poat ia aber,

4St and 'Namber} recey (State) ine yet trys hE ev.
’

CITIZENSHIP . USA... weteereee ADDRES

j 5 Xaingenance WE USA FE

4

i

1 3

Sol, Paul Zehrung -xecationsmp 224822 age 38
i TYPE AND LOCATION OF SERVICE (IF KNown) Divressor of Xajnse

a. RELATIONSHIP ..
Waghinstan, D. 0, USA

“SV asd Nuinber) 77 estate Geant

: NAME. Ja jor Jaek unaek Lin

p

crraunsate . 95800 ADDRES |

TYPE AND LOCATION OF SERVICE (iF KNOWN) Pan ABO, raimags Son,.-D. we gin vee

lir

3 NAMB wT! ww RELATIONsINe AUES AGS.

appress 513. N 29th St. Billings, Mont. USA

{Si ard Number) rrr ‘Sent an anagy

, crtzensutp USAC.

! : TYPE AND LOCATION OF SERVICK (IF NuwN) SOCiS1 Work = Dent. of Intertor
@) -located in Kortana fa arts

SAO RT Uma, oe UN RLe aN eee a nena

ISRO TPE Pr spear erat een petimerippetmipesecriecea renee er eue vm

14-0000

MISSIN Tastee

i Spire,

Te camer a Eh Site 208

(8)

Src, 12. POSITION DATA

A.KIND OF POSITION APPLIED For... Adudnistrative. position with Latin...
AmeriCa, Economiat, Statistician, or temporarily as a

we BOOS COPDAL..ccecececcccceseaces sceneecaiecssessesecesseslensseaectenses sctesesesuecesasesepeteceeesccsscstssesasesponnoncee
3,100...

B. WHAT IS THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT? 3 _..
(Yea Will Not Bo Considored For Any Position With A Lower Entrance Salary.) - .

GIF YOU ARE WILLING TO TRAVEL, SPECIFY: OCCASIONALLY ........AR~--—2-—- 2. sscnenenaneneve

FREQUENTLY 200. nccccccscesseusccccsnsnerennecessstssseseuny CONSTANTLY. 2h ctenccssssssseresmecensnen som somes mmecemeeae

D. CHECK IF YOU WILL ACCEPT APPOINTMENT, IF OFFERED: IN WASHINGTON, D. Co ver neernve
x

ANYWHERE IN THE UNITED STATES ................ QUTSIDE THE UNITED STATES ....

E.IF YOU WILL ACCEPT APPOINTMENT IN CERTAIN LOCATIONS ONLY, SPECIFY LOCATIONS:

int Sab OM i SEE: Smo LBA Ef co OTR RR Cen a CE SE

1

Sec, 18, EDUCATION .
ELEMENTARY scuoon 4098, Garrolltpnsest Carrollton,'0. USA.
(tity) (Sate) (Countez}

DATES ATTENDED 2999 — 1944 GRADUATR? F898 eeeeeee
, Ohio “USA -

(Contry

HIGH SCHOOL OMAR west de Debchtents
(Cl (State)

GRADUATE O38 eee
USA

“eanter)

| TRANG” % Bop h
MAlon AND spRolaLry Eeongsded & Spant shears compLeren wb
BA -

55)
DATES ATTENDED ., 3946 19S ee DEGREE Teeter scree reenn aee cee

councn Universidad de Sun Cyadpa, Suatenala
(City)

MAJOR AND SPECIALTY ...SPSNish oo YRANS COMPLETED 9 credits

DATES. ATTENDED ...... 2224 2 Doe

EY. apperss Syme

Syracuag Univ
eee City)

COLLEGE 2

seerterees. 5 pe
(State)

"ery

DATES ATYENDED ...... Suaner 1948 oo pecneg.. none given,

CHIEF UNDERGRADUATE COLLEGE SungEcTs .... economics ~ statistics _

Ry +
etait eee ne reee ee PE Rah. gcomges pat 2144 OTe Fura...

CHIEF GRADUATE COLLEGE SUBJECTS oo eecee cere

2 DP

Clty, Guesemala CA

FERRE SRT oneerremene ecrerenm ew vase

14-0000

ry » ~ - - a Soe ee
Sea M. ACTIVE U, 8. OR FOREIGN MILITARY SERVICE none
eee (Garante yy ee ct), [| a nn Teo.
stneeiesenraeces Gia Bacay rc GEE Wey Ten page a piace

REMARKS: w.....0..02-- es -ncncmncetsanestocnerstrarcmetonemecoeeamsnnss

SELECTIVE BERVICE BOARD NUMBER... 2-20... ADDRESS 000. occcesstsssssesssessoteesnssaseeeeeomnectstonanuensone

IF DEFERRED GIVE REASON ....ccsnececiees sonresencerneeneeentencenceneerssneaensasnsnsasenosensoneestessaseressensesaseanen

Ae hy

wy
: INDICATE MEMBERSHIP IN MILITARY RESERVE ORGANIZATIONS u......nectme ren eece

—
Sec. 15. CHRONOLOGICAL HISTORY OF EMPLOYMENT FOR PAST 15 YEARS, ACCOUNT

4 FOR ALL PERIODS. INCLUDE CASUAL EMPLOYMENT, INCLUDE ALSO PERIODS
. OF UNEMPLOYMENT. GIVE ADDRESSES AND STATE WHAT YOU DID DURING
. PERIODS OF UNEMPLOYMENT, LIST LAST POSITION FIRST, (List all civilian em-
j ployment by a foreign government, regardless of dates.)
: 4/51 CLASSIFICATION GRADE

FROM 0. ZOE eeeeeeeee To - (IF IN FEDERAL SERVICE) —..

: EMPLOYING FIRM OR AGENCY ,., E9ard_ of Geourapito Wamog
+ Interior Bldg. ;
Z ADDRESS —....6..6. 8th Stat, Ue, Washington, D. G. USA |

SE DE, Teh cht abe lindacee

. (at. and Number} (Citys istnte) mantey?
: : an

; KIND OF BUSINESS eoccscccccescuessndecersesaee wame or sureevisorvas bkldred 3.00 7m F
i , : .
, TITLE GF JOB uy gs 29 GSO pee Fe

4 7 ara lt H
youn putieg ...... craving dire Grafting, typing
+ - ae scene cee wresteTecoeesdeocense toes - ~ ~

CLASSIFICATION GRADE
. (IP IN PREDERAL SERVICE) ..

3 , 2 fe, .
rom 8/69 po

EMPLOYING FIRM OR AGENCY... 880 (00 Gordons, ING.

a te Bor 2  F1 hte

AbprEss ..... 20% 240 Layton 9, ite Be 22 Cake we
tan aad “Number) (Citas (Stated .

xq
KIND OF BUSINESS PUTSEPY vase or supervison 22”.

rite oF son... SLOPE SALARY. 3420 cee

keeping, acadnss shed

YOUR DUTIES ..... baal
gw Wrelesalo, makicg tlorat aepenge:

re porta ’ ozcends

REASONS FOR LEAVING....29 beks u jok sore in lire
: tea) ; waged


14-0000

e
+

NE easton

5/10 CLASSIFICATION GRADE

£/60 CAT
(EF IN FEDERAL BER VICE) o. nccorecemeremeres sete

PROM occ TO le easrateese oe

EMPLOYING FIRM OR AGENCY babdional. Peanut Couret) oo
appresg ..i11 Dipont Cirele Eullding, Washington, £. %. USA :
(Gi (State) (Comenry)
pals

(Dt and Humtery
. NAME OF SUPERVIB0R LP “ilies 3

TITLE oF Jon ASSt. Pookkeopor  gararyg.. CC pew 2 :

KIND OF BusiNEss .TPACe A199C.

your puties ... bookkeeping, f1line, goneral office work, firancial

eports

deme etter cares oteasasras mteea nee nied = LIE te M TALES OaMPE he DEE bre aad SSEEE EO EE:

REASONS FOR LEAVING... roturn..Lone..bo.velp.my fether in bis business

CLASSIFICATION GRADE . *
L470 LIT icine TREN PDEA DEREIEED oc csec eee ese eee fy

FROM 00. Lee
EMPLOYING FIRM OW AGENCY... Prdeidodtva, Qenarel Loto ra ec eceee

Plent #2 Tayton 9, Ohio USA
it

ADDRESS ou. cess secceeccceeserctccses mes snracstser sinner lea cagnncneerte byes cnisciecterere
. and Murnlery iCity) (States

(Hi
Le ccecen NAME OF SUPERVISOR ES s

|
i
ot SEIS SAORI 2 AES PGS TIM SEEM LOMB an ar Gast 9

Fee awe tutus

KIND OF BUSINESB

TITLE OF SOB cececcsecssectecssccecsurpreneceeressves mesmiee BALARY Qiececmerencencerscersee VERE eccsscecanecussnsiveee me
‘oP b hovesto-

your puting .........0%fLe9 work in tre chemlesl lehovstertes

: wore in Bae fuctory proper

REASONS POX LEAVING wc OEEOTLED COMER ee

4nd UE
FROM ero OTB

ven CIP IN FEDERAL }

EMPLOYING FIRd on aAGENey,...CRents 5/10 Store

- LEB RUSS.

eentys tAln

ADDRESS ...

a thea

KIND OF nUSINESS 32975000 NAME OP SUPE RVIEOR

TITLE OF SOB 0 RIA ee cececneeecenccceseee SALARY § cece cece eee PER oe cece cece

0 See rsnent

your puties .. Wadbad oa cua:
:

tat
REASONS FUR LEAVING) 22273 |

Cc]
8

14-0000

od . So

16 HAVE YOU EVER BEEN DISCIIARGED OR ASKED TO RESIGN FROM ANY POSI-
TION? HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU

DESIRE TO EXPLAIN? GIVE DETAILS;

SEc.

caper cena Oceeamnstnetineestinenaneentetntnnetntennarmnntettretnnestntistnthfaumesn

Weta tetas ene rena nthe nets eetienrsmne: een nate e eaten ntnns cores nates Mae eben eben enenas beeen ager ene ene hacen testes ran aeen, Oeeneasenaaal fee rirrer renee toons)

= PIRIEY Se cette eg TE IT PIE RT EE TOE ATE NI TS a A SS SORBET 8 BENS te rt hie ee STRIATED

Sec, 17, GENERAL QUALIFICATIONS
° A.FOREIGN LANGUAGES (STATE DEGREE OR PROFICIENCY AS “SLIGHT,” “FAIR,” OR
“SLUENT")

lua

READ f WRITE...

. SPEAK Sf

LANGUAGE

LANGUAGE .Franch... . SPEAK alight. reap £agR Uw weirs L9Le

> LANGUAGE Leer eee we BPRAK oleae READ Lee WRITE Co cece eenstecene

DEGREE OF EROFI-

. BIST ALL SPORTS AND HOBMIES WHICH INTEREST YOU: INDICATE
CIENCY IN EACH:

j Art- ~dvawing , painting, crafts, studied at school ~ good

Enithing, “good; Basketball, fair;

: dere eeen anes

Reading;

GMUAVE YOU ANY QUALEFICATIONS, AS A RESULT OF TRAINING OK EXPERLENCE, WHICH
MIGHT PUD YOU FOR A PAITICULAR POSITIGN?
ro in (Gus temats, diving: with wo Gh

: 7 “Loarning the life ond | ways of | a spans sh Pandy and ofty.
3 saeveeas sereSeee dteneweaee Ceeeene tnaneae re rere caer nn ~ shee sege enna etre teense ree nd deat emecen see cmanernnnnaee
. I have gulte # complete imo wedge of te fl

: h & period of avout 3 »

{ .

a D.LIST ANY SPECIAL SKILLS YOU POSSESS AND MACHINES AND EQUIPMENT YOU CAN USK,
SUCH AS OPERATION OF SHORT-WAVE RADINO, MULTILITH, COMPTOMETER, KEY PUNCH,
TURRET LATHE, SCIENTIFIC OR PROFESSIONAL DEVIGHSs -

calculator

sHoRTHAND . 79.
38- arta

APPROXIMATE NUMBER OF WORDS PER MINUTE IN TYPING —. 5Q,
@)

eM ROROOR Menuet ee Kote ee

en

14-0000

aay

tHe eae see ween

E. ARE TOU NOW OR WAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY
TKADE OR PROFESSION, BUCH AB VILOT, ELECTHICIAN, RADIO OPERATOR, TEACHER,

LAWYER, CPA, ETC. |.
mons ro

1¥ YES, INDICATE KIND) OF LICENEE AND STATE ...

SAAN Sot dea S LN nce gg

FIRST LIC. OR CERTIFICATE (YR) —........ LATEST LIC. OR CERTIFICATE (YR) «00.0

¥.GIVE ANY SPECIAL QUALIFICATIONS NOT COVERED ELSEWHERE IN YOUR APPLICATION

SUCH AS:
(2) YOUR MORE IMPORTANT PUBLICATIONS (DO NOT EUBMIT COPIES UNLESS REQUESTED) .

{2) YOUR PATENTS OF INVENTIONB
(3) PUNLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE,

!
{
H
i
|
(4) HONORS AND FELLOWSHIVB KECKIVED |
|
t
i

wu. SAL did a:lot of extenpt and declamation work Jn public speaking

:
i I 2.) a ee

el necelyed a partial scrolarsnin from Coane] ob Syraguae

; ; i

PE acon

G. HAVE YOU A PHYSICAL HANDICAP, DIBEARE, OR GTHER DISABILITY WHICH SHOULD BE j
CONSIUERED IN ASSIGNING YOU TO WORK? IF ANHWER IS “YES,” EXPLAIN: :

HGO YOU REC
” GOVERN E

FOR MHATARY OR ON:

YWUNDRE ANY BETIRBEMLNT ACT ON ANY PENSION O OTHER COMPENSATION
VAl SERVICE? [EF ANSWE® IS “YE3," GIVE COMPLETE DETAILS:

Sree seme antlns miter Sahat WIN awed’ ae

15 Ore 8y—4

TERETE SIT IS eer sersane wrens:

14-0000

@ @

Sec. 18. GIVE FIVE CHARACTER REFERENCES—IN THE U. S—WHO KNOW YOU INTI-
MATELY—tive residence and business addzwsses where possible.)

Steet and Number City State
x Min, John Lewis 00 nus ann _OSkwood Eigh Sehool, Payton, onio
RES. ADD. A ee ce teceete | meceneeeeeree -
g Mee. Herbert Haldernan _ 7 £2, Dayton 9,0nLo
™ RES. ADDL wah
: -_———a-bin, Albert F. Kuhl, Deus apn Serries Bldg. —Pexton. Ohio _.
_ ; Res. ADR PA

Xr, _ George fohlnayer BUS ADD.

Me

x RES. apd. —#.
: 5. kiss Katherine Sith pus apn NA
- RES, ADD... §9 Wiltshire Dayton. ‘9, “Ohio...
ER TE EI ae EE = sapere cies Sees oer eee te se
Sec. 19. NAMES OF FIVE PERSONS WHO KNOW YOU SOCIALLY IN THE UNITED STATES—
NOT REFERENCES, RELATIVES, SUPERVISORS, OR EMPLOYERS—(Give residence
“ ...._ and business addresses where possible.)
. _ . Street and Number Cita State
; i wikss Teadesha. Loran... pus app. A... sees -
2 RES. ADD. Rae 2. Cazenovia. NOY.
g,... iS. Bd Bastin = nus apn San Rae Gardena Layton 9, Ohio
s RES. apa Pease. Ave., ‘West. Garr ollton,..chio
‘ 3. ...... Miss. Setty.Hollia_... BUS. app. Arlington. Arbx,.Avlington,. va.
. RES, ADD. 140]016th.St.,.0),. i. Washington
4.0.63. Haber SeLwerté oo nus ann od of Syracuse, Syvacuge, N.Y.
RES, ADD... a
Be wnt ational bani, a
Y 2. i Q .
Ske, 20. GIVE TH AT YOUR LAST NORMAL, RESIDENCE IN HE U uU 3
: (Give resifenee and busines: addresses where possible.)
‘ Steeet au ather Cily State
: ur, Rar 2. NeKecnnie oo sus app San hao Gardens, Payton 3, Ohio
i ; RES, ADR, _... SSue *
school )2. ww. BUS ADD...
neighbers RES. ADD.
RUS. ADD.

pesos eee ee
Src. 21. FIN: ANCIAL B: ACKGROLN D
A. ARF YOU ENTIRELY DEPENDENT ON YOUR SALARY? ... 29 1P NOT, SPATE SQURCES

LTD

EXTYSUIER persseeteerromm trou ene

14-0000

.

i
H a2) .
i C. HAVE You EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY? ......
: GIVE PAKTICULARS, INCLUDING COURT? ...
i dD. GIVE TI THREE 2 CREDIT REFERENCES—IN THE U. 3. ~
i 1, NAME ....eredian E111 liote] appress (260l-16th..St Uy. jHaahinsgen-DC '
‘ awame EPS. Bite apparss 140L=1eth St, ashinston Te
z Lt ity) as
3. Name Delta Gonma Sorority apparss SOL Valet. hyo. +, Syracuse NY.
U3 and Number) Venyy (State) :
_ a '
Sec. 22, RESIDENCES FOR THE PAST 15 YEARS . j
FROM AedeBh To...Present 1401 -16¢n Stes Malla Maopingtens DG USA; :
(81. and surter (City> (Mate) (Counuy) : 1
prom 6-60. 70...425h.... haiti NL aa
(8, and punter)
FROM e750. TO ... fd Ma ishington,. PGs. USA H
° (Btate) (Country) H
prom 2248 ro... : . |
7 a
FROM 27 =46 70... 27488 two cosregea of Syrecuso Univ, siracuee i
(34, and number) iu (Mtate) {Country} t
rrom 7748 go £788 C1P. OO Guotemula City, Susterala '
: (St. and mursbes » (Chay) tRtnte) (Country) ;
rrom time defaye this San Noe Gardens, Layton 9, Ohio USA
(St and number) sony) (Btate) (Country)
FKOM .
Sec. 23. RESIDENCE OR TRAVEL OUTSIDE OF THRE UNITED STATES :
A. FROM _... 7946 TO oT Nox go Cit a. XZ rexico. oe tou ist ee
“(ney 4 Purpose)
Gus vtomela. . .

rrom...7*48. 0 ro 8+48_000G

PROS oo oe eee TO i cee

teep

a

FROM | oo ee TO oe eee ee

FROM .

Sec, 24. Chit URS, SOCIETI AND ONE R ORGA SIZATIONS
: LIST Nantes AND ADDRESSES OF ALL CLUBS, SOCIETIES, FROVESSIONAL, SOCIETIES, EM-
PLOYEE GROUPS, GRCANIZATIONS Ub ANY HIND CLUDE MEMBERSHIP IN, O16 SUPPORT

OF, ANY ORGANIZATION HAVING HEADQUALTOSS G2 ERKANCILIN A FOREION COUNTRY) TO
WHICH YOU BELONG OR WAVED BELONGED:
Delta Gomma . ~ Pho 90) Wala Ge, Svracuge,

(Name tied Chapter) 7" “ost ant Number? Cis) er

1947-50 active - 1950 to preannt tractive .

Lo...

DATES OF MEMBERSHIP: ..

2 Spanish Club Syracu se Univ., Syracusa, vi. Y. USA
“(UNane and Chapters 7 . TEBE and Nee 9 1s? “Yotaty een Mane
1 -
DATES OF MEMBERSHIP: W ea a | 8 cena anee Men ceetnee sesaneeeneseue: oer ~ wees tees
a, _ Beon Syrac
"(Name snl Chapter) Sh ad

O48. De
DATES OF MEMBERSHIP; | 1948 “9 cect ge ep ee gees guys twee
¥ Westminster bran ayoeplan ct :

7. Browntos - Grace Setool = We

2


14-0000

—_—
Jo. Girl Scouts - High Sv ool = Best csr-olton, Oro

ft. Honmador &, - Weatniustesc Pres ztar€9 Church - Dayton 9,u, .
u

194504 . . ak
f€. Alumni Association of Syracuse Univ, Syracuse, i. Y¥. USA

195D-
a W.Internatilonal ‘Rolations.. Cloud. Sesacuss. UshY ».. Sy: TROUSS. 3

“(Ratoe and Chapterd (80 dnd Nuinber? reer

DATES OF MEMBERSHIP: 1946272809 ene egeennnnenstannee

USA

¥. US

& 2nd & ist Cadinot - Crepel - Srracuse vniy,, Syracuse, NZ. Wes
(Name! and Chapter) {Btate) (Country)

DATES OF MEMBERSHIP: ...

& National Yorensic League « “Oakwood High School, Layton 9, 0. VEA
= rr Name and Chapter), - _ (Bt and Number) ar a "(putes . spennemseees “Yeooatey

DATES OF MEMBERSHIP: ....194528.. 8004V@ ne laecanee
high school sorority

a Sigma Theta Fri + Dayton 9 Ohio USA
‘ Sane Name and Chapter) tales “|
DATES OF MEMRBERSHIE: .
en eS SESS EE
Sac. 95, MISCELL ANEOUS :

A4:PO YOU ADVOCATE OR HAVE YOU EVER ADVOSATED; OR ARE YOU NOW OR HAVE YOU
EVER BEEN A MEMBER OF, OR HAVE YOU SUPPORTED, ANY POLITICAL PARTY OR ORGANI
ZATION WHICH ADVOCATES THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOV-
ERNMENT IN THE UNITED SPATEST

. NO

IB WYES,” EXPLAINS (ccc cece eceeeeeeece seceeeceeeeenenearemnisninn acecveeseeeeas sr cenenteesaneseneecoaceusensecesasoreese

BDO YUU USE, OR HAVE YOU USED, INTONICANTS? ..XES oo ee IP SO, TO WHAT :

an eccasional drink at dir sera und ‘parties ‘

EXTENT? .

CHAVE YOU EVER REDN ARRESTED, IN7 BOANY VIOLATION OF
LAW GEHEK THAN A MUNOR TEKAFFIC VIGLATION? IF SO, STATE NAME OF COURT, CITY,
STATE, COUNTRY, NATURE INSE AND DISPOSITION OF CASE:

\ { \
: “UF ANSWER IS * “YES GIVE DETAILS PELOW: , :
nO ooo ooo

BLIST BELOW THE N

NAMES OF GOVERNMENT DEPARTMENTS, AGENCIES OR OFFICES TO
WHICH YOU HAVE APPLIED FOR EMPLOYMENT SINCE t94u:

seater:  Gouncil.of.

JOPALS DPA:  dboude. Buergy.. Cou.

~-Beonomia Advisors; round of Geassva pide Langs.


14-0000

a ater)

Ane et

qr)

FIF, TO YOUR KNOWLEDGE, ANY OF THE AROVE HAS CONDUCTED AN INVESTIGATION OF
YOU, INDICATE RELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATS OF

THE INVESTIGATION:
Board of Geogrspnie Names 4-1-5)

PO Set og etree serrate SR be at PM eT RES NET TD

Sec. 26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY:

NAME. ....... 89muel D. Zenrung _. ceonenmane RELATIONSHIP... £6 ¢h er
San Rao ‘Gardena, ! Re Rv il ‘Dayton, 9, Ohio USA

ADDRESS ...... echteaeedonees 2, cesesnecorsredyserctvanseneanan
: (St and Number) “aie “tated (Guantry)
ALES LEAL ORR EEE 5 SETS he a en NNER ROE SOE TS

Pat LB ODIs ETD TS,

Cee RET SL ES

Sec. 27. YOU ARF INFORMED THAT THE CORRECTNESS OF ALL STATEMENTS MADE
HEREIN WILL BE INVE STIGATED.
ARE THERE ANY UNFAVORARLE INCIDENTS IN YOUR LIFE NoT MENTIONED ANOVE WHICH

MAY BE DIZCOVERED IN) SURSEQUENT INVESTIGATION, WHETHER YOU WERE DIRECTLY
INVOLVED O# NOT, WHICH MIGHT REQUIRE EXPLANATION? It 80, DESCRIBE, IP NOT,

ANSWEK “NO,”
tO cecser wnetenentetnneenseesaeeagunecnneteneeunnstenereinec eanggeeecane

pate

trerte avereistess = . ee oer

Sec, 28. 1 CERTIFY THAT ‘THE FOREGOING ANSWERS ARE TRUE AND CORRECT TO THE
BEST OF MY KNOWLEDGE AND BE ree VANDTAGKEE THATANY MISSTATEMENT
OR OMISSION AS TO A MATERIAL. FACT WILL CONSTITUTE GROUNDS POR IM-
MEDIATED GISMISSAL OR REJE <CTION OF MY APPLICATION,

. 6?
- SIGNED AY. Bhd artes. Saee AO DATE Tey. 2

we acu Statef
° et f
fb nt 4 Read Come: ;

Wane

rt ae
he. Hues athe Pee ter,

sSematyre as 4

USE THE FOLLOWING PAGES FOR EXTRA DETAILS, NUMBER ACC CONDING TU THE NUS xM-
BER OF TUE QUESTION TO WHICHE THEY RELATE. SIGN YOUR NAME AT THE END OF
THE ADDEG MATE IF ADDITIONAL SPACE ES REQUIRED USK EXTRA PAGES THE
SAA Side. AS THESE AND SIGN BACH SUCH PAGE.

@ OR wteqeuntar meat ey gece


14-0000

aye

oe

CT ee ne ee EeEEEEEEE
Seo, ll = br, J14 sohruns, Sr. Uncle. él.
USA 1210 Wilson Dr., Inyton, Ohloe USA
Nechanical Engineer - Wrig:t Air Field,
Dayton, Ghio

\
\

ay Me ey err sweetness etme mee

14-0000

. y
‘ CONFIDENTIAL yy NY
SECURITY APPROVAL” / 3
Data: 16 Oct. DR

Chief, Covert Fersonnél Division Your Reference: L2b19
t Chief, Security Division ’ Case Number: §68h0

SuasECT: ZEHRUNG, Charlotte Louise
1. This {te to advise you of security action in the subject cane ag indicated .
below:

(YJ Security approval {9 granted the subject person for access to classified
information, : ‘

Frovistanal clearance for full duty with CIA is granted under the provisions
of Paragraph D of Regulation 10-9 which provides for a temporury appoint-
ment pending completion of full security investigation, .

The Director of Central Intelligence has grented a provisional clearanca
for full duty with CYA under the provislong of Paragraph H of Regulation
1C-9. . .
g. Unless the aubject feracn enters on duty within 60 days from the above
date, this approval becomes Invalid.
Subject 1s te be polygraphed as part of the ZOD procedures.

pees
Ve oll? . ” 4 = }

BA
we

CEST IOENT TAL

_
EOE ain

14-0000

Od ~ .

Qe ,
ae "CONFIDENTIAL

As af
\ INTEROFFICE MEMORANDUM

Date: kb August 1951

%0: Chief, Covert Personnel Division
FROM: Chief, Security Division

vOJECT:: ZEHRUNG, Charlotte Louise —-S6BLO.

1. Reference is made to your request for security clearance of the subject

pereon who ie being considered fur employment in the following positions
2 This is to advise you of the following security action:

a. CX) Provisionul security clearance is granted to permit subject's
employment on 4 temporary basis in the following urow or In the following

capacity: D Street Pool

This clearance ia granted upon the condition that subject: 1.

not

Ve ccesas Oo Chass ig Fg eria . ho AY WOCRRY @ gecure gre ;
have a L 1 ified mat 1; 2 toh t as;

3. not be iusued a badge ov credential;:4. not represent himeslf ay

3

CIA employes; und %. not be assigned ty any unelusoified duties other

than indicated abova.

b.CJ Nume-cheaka have been completed on thie pervon. Arrangements
should now be made by your office for an interview in thio Diviaton.

Bpon

completion of thia interview further consideration will be given ta the rem
quasted Limited clesrunce for uecess to information slansified no higher than

~ Seeret. [f subject hus not entered an duty ander a previously grastet (Lr

dinagnal gleurance the interview should p46 arranged ofter entrance on duty.

c.f J Subfect in sseurity approved for temporary appointment to 4
tion requiring accesu to information classified no higner than ret.

% poul-

Officlals of the employing office should be advised of thia grecu-

pity limitation and ahould be Lastructed to supply Purare ous
A nore

advice es to the limitation se ay te insure gentinued compliacs

Security setion to offer fall »pproval is continuing and your
office will recetve advsee of full clesrance upun cumpletion of
action, Upon receipe of full security clesrance, the presest li
will ba rescinded and aupurvisory should be advised sccordingly.

- - tua sel,

804 DLE Iq

i

abe

CONFIDENTIAL

Foss eA.
jin, 1934 FEES

erigers aith


14-0000

ere ARIES MO AAR, TESA AL Bhi 2 eel Ubaa aS al edt eee heat

p

DEPARTS NT
cr
INTURTOR

TO een nina ame nicte eens cee eran one st 2

14-0000

OF eee te LE ee LS SD AR ee ENS SO OOS ON oe EE ee eS mR DY es as ak a oe oe re me

’

*  WwalTED STATES) @IMENT OF THE INTERIOR &
Led MGI Gt PAO... 0 LE EVTION AND MAMAS aatal
WASHINGTON 0G Date of Action . Journ .
ree 900% pode
Rey Zies Cherhethe Le Zabmemg ofo “Ls of
Sen Ras Gardend, Mette 11 0.00" Poruanent

Dayton 9, Chico

IHDSVIBIYS APPOLDTIGEY

~ Effective Dote: Apyil 2, 1981

Position -

Grede end Salary

Bureeu

Branch Divieies af deer rachy

-*

Heedquorters

Depenmental
orfField  *

. Gp 1%, © saptha Bo Koid

thie appolatzens 12 cunfeat te a trial porled of ono yoare

Sudjess ¢9 insesbizabliene

“Wrtaz tite sppulniment yoa wihl he covered My the Mathonal

Snake eauriey 2, e@iine

a '®) ems Porauinel ufsiser
Aga.) = Sige od CRM exit Pancaae

We brech Dies of ta Saeretay

Appropriation Tote: i 3 Soph
Gen opeia kena, Semityg YU
ASTKITATION Renbee alnctou 2 Gttntal rretue tor the action receamerteds

Bisa tetera
Sorvice Certivies x 1625510

dep Savi Sa
Pay presigarelaisen’ Joya lay

6-2-5138

OORT sceste BREAU SOTHICATION COPY

20

Bears ozieal Draftexan

G8—3, 82650200 per annus
of ee FS)

Hathing ton, De Co
Departwental

ot, TELLER

Se OE Vowgd Ay Puma, Ivaeovier, heard oa

0 Secn solepted for gppoicinuas fen viva d

Politi sepeyn, snlisnl cert Pieate, and Fors a
engay are ¢cbachad,

a" PCR ORT a
Gtity UGAL AUTHORITY,

fog ilar

To

r_|a

_ a
conv 1 SfA108 CHANGE
APPOINTMENT

sooretary

Biro)

Tp

fa Mae iam

Wee Fe Abd. btenticss me

Nee Lorthe BeReid
Clad hES~3aEC4

Dea ieee et cme eee

|
i:

spe

C8 Certificate vo,

Be75A0 dated 1/r6/5r.
Cote Fege 2,115

ng _.
HA tuke OF PORNO

Cee ed tan lon

_jf¥ Cnie

EIA TS PT


14-0000

GrANDARO rone softy savt) wee UNITED STATES rome TER
crate. Senerce eon SSION \RTMENT OF THE INTERIOR g. Jojo q § Rey
OCTODEA 1946 oe 2 ON

Orr ics OF THE SSCRETARY ooo 4 °

NOTIFICATION OF PERSONNEL ACTION

1. NAME (MAL M108 —MRG.—F TREE MIDDLE INTTIAU—BAgTE 2. DATE OF BIRTH | 9. Joumna ca Acton Na | 4 paTe

Tha ta fo th a yu of he fatecin eleva affecting your employment:

J y NATURE OF ACTION (usd STANDARD TERMINGLOOY) @ REFECTIVE OATES | 7. CIVIL SERVICE OR OTHER LEGAL AUTHORITY

oy
6. POSITION TITLE

& SERVICE. GRADE,
SALARY

Office of 3 10, ORGANIZATIONAL
BIQNATION:

Division of Csorraphy or 3 :
Research Brash ; wee

11, HEADQUARTERS

Rashingtesty Do Co
{ ] FEL xl DEPARTMENTAL 12. FICLD OF OCPT'L [ FiKLO { { DEPARTMENTAL

13. REMARKS

Ang lesve reaniviog te your eredi$ will be tranaferrede

yoparated withows renzlegmen’ wightoe

Sa RAAT OOTP

SNFIGATION AGT acrion

Veet hh

Tye. POSITION C1

eye

wen]

t
OSS WBA TE OF OATH RR LEGAL RESIDENGE
AST | Waccenmons oncel

fh ager e
we ineed TOL APPROPRIATION 2ASSGUT.OSS Berking

| omy oa istariars OPPice af tho
mise. {alal 4}

J TO
See caviar? : =:
SOG eceseawree sect YOKE ee Re

4, PERSONNEL FOLDER COPY

Cnn Seeree


14-00000

:
!

PL ee terete Gt eer

~

[ote

‘Give tls card fa the
arrounaiad CLERK

the - inet
Pus OUTPATIENT CUKie 1
4th pad © Sirects Sw, " Cha
EL BH Est 8 ea)
(er Goss 176) PATIO
2
| Statistical Draftaman_ _
. . at
a. oare of orn 1/29/29 ng an acscoetunn on wage ear?
AT THE SERACE CHICKLO BLOW,
4 [DJ pwor-ruccrocran 0. [“] on cym C1 paoraree is. [_} muterion
MP CACAL 7 TTT ane s, MENTAL
CJ recrnarion 9 [7] pia mee, 59g Mee det, 7. im MCALTH
[CU] vepopatcer te [7 searicay Sef puer | 1, [7] otawaréiosy
, fo} ecient [7] protons ss, {J cue.

of 3

| 21, AMES A

MEOICAL APFOHNT MENT A4D REPORT


14-0000

Seo ce ee

4

4
i

aa 26, Cdl. 3. Cone Le.

“

™

STANDARD FORM 61 intvisto arent 160)
PROMULGATED BY CIV FEel ie COMMISSION
CHAPTER AG FEOTRNL PUTS ONNEL MANUAL

APPOINTMENT AFFIDAVITS

IMPORTANT.-- Before swearing to these appointment afiidavits, you should read and understand the
attached information for appointee

heaters?  eecceeesecee! Lhe... ee reterry... BCH SAB Pat. Bis Coe
‘Drpariment of agency) Geog epny ue division) of employment)
1 We case htt hee Leta. Fhe “pe sessenenseeaes , do sotemnly swear (or affirm) that—

A. OATH OF OFFICE

I will support and defend the Constitution of the United States against all enemies, foreign and
domestic; that I will bear true faith and allegiance ‘to, the same; that I take this obligation freely
without any mental reservation or purpose of evasion; that I will well and faithfully discharge the
duties of the office on which I am about to enter, SO HELP ME GOD.

B. AFFIDAVIT AS TO SUBVERSIVE ACTIVITY ANO AFFILIATION
Iam not a Communist or Fascist. I do not advocate nor-am I a member of any organization
that advocates the overthrow of the Government of the United States by force or violence or other
unconstitutional means or secking by force or violence to deny other persons their rights under the
Constitution of the United States. I do further swear (or affirni) I wiil not so advocate, nor will
I become a member of such Organization during the period that I am an employce of the Federal
Government.
C. AFFIDAVIT AS TO STRIKING AGAINST THE FEDERAL GOVERNMENT :
Tam not engaged in ‘any strike against the Government of the United States and that TI will not
80 engage while an employee of the Government of the United States; that I am not a member of
an organization of Government employees that asserts the right to strike against the Government
of the United States, and that 1 will not, while a Government employce, become a member of such

an orgunization.

D. AFFIDAVIT AS TO PURCHASE AND SALE OF OFFICE

T have not paid, or offered or promised to pay, any money or other thing of value te any person,
firm or corporation for the use of influence to procure my appointment.
E, AFFIDAVIT AS TO DECLARATION OF APPOINTEE

The answers contained in my Applicatian for F
dated _..... ADM Og... eee 1DIO., filed with the shove- named epaetnent, or “agency,
which I have reviewed, are true and correct as of this date with the exceptions noted in the Declara-
tion of Appointee on the reverse of this form. (If no exceptions, write “None” on the Declaration

of Appointee.)

vee Cheartatiig ewan a aan

(Signanue gf tire mtee)
Subscribed and sworn before me this ...... Gl... day of 4-5 A rAhaee  A DL 19 §
. — a
7] f City) yak? (Seated ;

seat] a“ lo . (Osan tore of offen) go ey a
t ag yo LDaall Minaig ‘ 4,

Ge er . ALiy- ee. y om
NOTE.—-If the onth is takan before a Notary Public the date of exptration of Ais soma mised shou! fa
tO OL4O-$

bo showa,


14-0000

WECLARATION OF APPOINTEE

This form is to be comyleted before entrance on duty. Quertion 3 is to be answered in all cases, otherwise
answer only those questions which reguire an anawer different trem that given to the corresponding
questionson your application form, Lf no answers are different, write "MONE" in ftem 10, below. Any
false statement in this declaration will be grounds for cancelation of application or dismissal after appointment.

Impersonation is a criminal offense and will be prosecuted accordingly.

ameter tr
1. PRITENT AUURESS (attend and aumber, city and State)

Jp 1G He Sf _ _Weshiagven DiC

2 (A) Date oF mATH (2) PLACE OF BIRTH (city of town end State or country)

L11fag Daytot  , GY. USA
& (A) INCASE OF EMERGENCY PLEASE NOTIFY (5) PHLATIONSHIP | (C) STATET AND NUMBER, CITY AND STATE (0) TELEPHONE RO,
- ” ra fs . ~
Swrntudl DB Zehrung Futher lan lee Garycuns- RR i NWA SPSd
~
Fane
@. DOES THE UNITED STATES COVTANMFNT EMPLOY. IN A CIVILIAN CAPACITY, ANY RELATIVE OF YOUFS (LITHER BY BLOUO ON mannan) WITH WHOM YOU LIVE GR HAVE UVEO WITHIN
THe past ze monTHS! (_) ves
its 20, fot each euch relative fil in the Blanka below. It u additional apace ia neve: dee Tron
POSTION (2) TCMPORARY OR NOT

POST OFFICE ADDRESS
mama (Give attest number, a any) ComanT he hay thea Wa WHICH

Ps complete wes under Item 10.

eS
INDICATE “YES” OR “NO” ANSWER BY PLACING “X” — | veel Hg [a t08
IN PROPER COLUMN ig

10 SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS
WRITE IN LEFT COLUMN NUMBER OF ITEMS TO WHICH DELAILKO ANSWERS APPLY

3. ARE YOU A CITIZEN CF OF OO YOU OWE ALLEGIANCE TO THE UNITED STATEA? ..| x

8 ARE YOU AN CFTICIAL OR EMPLOYEE OF ANY STATE, TERRITORY, COUNTY, GR

ar unvatuatey woaration aftee $y ¢art acteie, amount of

suttrenment pay, wed untas what ratiramant act, and ating |

af ratised frani tuilitesy or naval services. :
BFR CAPE ETE LET A DISCARD ah EOACED TO RESIN, POUUNSS, {

Oot UNGATISEA I Git SLAVICE PROM ANY FOUTTION?, y yon

Mi yruranswor es Yeu, que in Itorn 10 thn tania and addtwes &

of amployer, date, antl tassoa tt each v:030.

Le

MURIGIPALITYT ae aeereseee weteerssacnece te esee

M your answor ia" You", give dotaily in Item 10, x Toren es
410) 100 APCLIVE ANE ANEINTY HOM THE UNE TED STATES Ui DIST EET ¢ i

COLUTIIA Gay AEE NDEI AMY RE ELRE ALE ACT OR ANY PUMICE ay verre meres .

GUT UE Tae HPAP TOMAS AL Otter g ‘ a

Marois umaseat is You! qtivn yn fram {0 reason foe poluratnent, | .yor | .

thal e, age, optional divetibity, ac by Coase Of eobuntary A baae tebere eee cee ce pene en te ee cea eenee cereeee feener es rerenweamenecee oe

SUIALOHED MIC UGE ASA DEETROONT IS Ciptachad PP
COTES BINED OR IMPURE CRILIEE DON
Ft TO CLMSIT BAL OC
BEGULA CH GR GROK,

Mf yaue ansvor ist dint atl aueh cates under Har i.
Una sntguch care wo wo data, (7) the nature of she otonda
ar vielanion; (3) the name aad dovatun of the court. (4) the

penalty imposed, fans. of other disposiion of the cace | ceccsslesnessncneus seageasenceeseenaenee seaaetesen sores
fl appointed yaur fingerpunta will be (akon !
Hl j pees ereeeenmenteces ceeeeege creepers tee sete :
ore rt iret enmeanenee a ee eer iecenen cement
_ . INSTRUCTIONS TO APSOINTING OFFICER
The apreroting officer befure whom the fereguing certificate ig msde shall 01) Crtsamashes ? ting officer is rexponabte for obterving the
Leta fatlindice — ctizenstip pee vetate of LY the Civ Sersne Mule nat CO bpprepaation eta,

Ferm @f isestitates an adavet fea beth purpesea and is deceptaldy juset cf
Gbeenebip rates in Use ahaee ul ie wedeuce, ta donbel it cuaet the
Prpraarnent sheads met IN yeuieucds oad arance hae been securel (ote
vihes of the Ctrl Sroive Ceamintian:

determine ty hep aon etiafaction (bat eee appointment wr otd
wih the Civil Seeviee Act, apphe able Civil Seavice Kudos ari
acts of Cemgress pertaining fo angeintine a

This form whould Le chee bedd fur hedltiog.
bowaths ony gecord Of recent din ba,

ike
t i WD endas (5) Sfanibore of Baenh Serie 9 of the Civil Sereiee AOC provides thet
ce oreinpeted wrth the apt cutin’ or Se Mm Eri eeete Ae. a

sol ageraiene anny be chr bed aqamt che inedat vortswate The
Ut questioned on ius personal history for agieereent 4th bee

iegelatsumy ated

fetice penmon, autatabey in cate
cour mirest, aiid pate uariy tre the | Lhe cestitys

aids pros tac

Breviuus apete
foread to

yes
he seferard (hat apheant 1 met aut
Dro suet deteciination ia meade, Ua: apps

Hf denaite oge timite Raye heen extebhabed fee the pewocn, tee abt
cotne wee Tings bec appers tia

nut be etnaursiocd,

BE Breed Orratens Gorin | 16 —edidaek eh
—


14-0000

SO
ra Z
Effective Dates qoncucouadanp x

o Subjeet to investization.

ee ne rage ee I NR NE SC RS SR RE Tn a I eet em ee Caen Lee SY Otte Gee eet at
, .

> UNEEO STATES O°" CTIMENT OF THE INTERIOR . rr

id ONTSON OF PURO, UPERVISION AND AAS AGARNT mo . - ‘ \
WASHINGTON, 0.C, . Bate of Auton : , downed i

-. Ret Hae Chariectte Ly Yehrung - .

. San Sao danians, RR. 1) ~ Permanent ,

CIVit
one Aunioury

CS Certificate Now -
H-2580 dated 1/16/52.
C.S. Reg. 2.115

setioa ,

“ Dayton 9, Chie

INDEFINITS APPOINTANAT

Regular :
Nar arene ;

Postion . Statiatioal Draftsman

Grade and Selary | GSe3,. $2650.00 per annua
(35-1533-3-50h) —
Bureau Gffiea cf the Seoretary "LAST Ste CHANG f
troa
Branch ; , pee of fe revhy to
. fPreesared
Heedavanes Washington, De a ——Etestne
Departmental , Pepartmental ESE carina ,
Po Haturt OF PORTION

on Field
Oo I. © Martha 5. Reid
This appolatzont ia autjeot te a trial “peried of one year’, ty

x

Vicetn Add, bfentical——

Nis Marthe HReid
“+ GSe1ES3-36504

Te, Rositosstton ee MeWiemee

. Under this sopoin brant you will ba cavered by the Netlorel
Ssolal Sseurlty sj acess

Jee Meme wel, x.
BATE Ths ATRRDNE INAS _

o/Ui/ ‘5 1 :

s on, —
ee ($0) THOMAS H. TELLIER noite oan
S . _— R ets adie anne
wo . pa verrareey)

F Signed! Pneaned Paewmnat — fae
.? io. BG Stow oon 7"
letica Tee i weere's
Agprondaticn Tice: Uy [ROG OOF Working Yund, Interior, Beard on : | Saee anne

Geagres he Mande, Sundry, 151, : ne

SUS RICANS Carlen ae Sen anions tee the getiar secones bead

Mias Sehrons has been aslesiiod for apvolacment fru Civil

Servive Gertificata N-f$f0,-

Wer Civil Service pavars, medioal sersifivate, and Fors &§ ——
. for praenppoiaisens dieyalty ohcok are attachods ene samen

Attechaente,

| eof era
. - -
¢ - ‘ i ie locandet Reaht AL

I - i
aN a scene CPARTMENTAL ACTION COPY | OSeS33- 3-3 of
Aare. :

14-0000

To a RCRA RACAL RATE. i ine thee Sy say mt as

2 A NMEA met Seah ny ee MeN feed eet

. tenes oe i ree eae tbe tea ee
ne “= _ .
REQUEST FC ‘ORT OF LOYALTY DATA ON AI «ANTS AND APPOINTEES
Chet pert ioe Opcomiaton —
(Ulepie D2, FT MO 3804 O88 TO AE UST ONLY FOR APPLICANTS AND ACCOINTELS CASE SERIAL KO,
Pet RECOND CHECK & AND INGHINIFS ARE CONUUCTED ave use ony)

BY Civth SLEVICE COMMESSIUTE
CPART leit culivl Ore 9495)

YO:
The following information fa furniclidl far identification purposes on tha pore named below, Kindly furnish a nport on any
foyally information cantained in yeu bier The focerprinta of Chiba person nie attached 7 .

(Athidle oF ote Bare)

1. FULL NAME (initials and (star anas (Uiven name)
tre ok oeeralhl, pane Zohrung Charlette Louise

2 ALIASES AND NICANAALS. 2. DATE OF TMS REQUEST
“ Sherr’ 2 ‘51

& SPECIAL NUMBERS KNOWN TO REQUESTING AGENCY (ENT punter oe FI fle wits, pamyaat nusabor, Anuy uf Navy sytias vowlee, eanian's cer) Graie of
Me Uneativg, sbea reyitineies Bude, Pool bouwity punber, ote, Kpeully which)
Social Seourdty Ho. 069-246-5135 :
& PLACE OF BRT SOATEOF BIRTH 7. TITLE OF POSITION ‘
Statistical Draftsman SENS

Jane 12, 1929 Mvision of deagra
% BUX 9. MARSTAL STATUS 1, IF MARRICD, GIVE SPOUDES FULL WAME, AND DATE AND PLACE OF BIRTH
(7) mane CF sinoe Kone
Kerevan {J MARE D.
TR DATE GF APTOINTMENT ame ne EN Vo ET uxcerte - j ae mane.
APPL BAP AE Kt Civil bervlor or utter best quthuaity) us ez 15

BATONS WIT WHICH ie BOTHER THAN RELIC THAN RELIGIOUS OR POLITICAL ORGANIZATIONS OR THGSE WHICH GOW RELIGIOUS OR POLITICAL

32.9

Delta Gazsa Sorortty
14, DATLS AND PLACES OF RUSIOLNCC FOa Tie LAST 30 YLARG
ny Ta Bret City State
9 - of San czas Gardens RR. . 12 Day ton Onie-
ote pany eprom Gk rabnot ve on Sera
Tf] --—- 9, i van tee Gurdene-- Day ten cee eee NO
| Xalmat ave tyrasusa .. L. Y. we
even Calla GuatecAla.. City... —tiumtenala Code

cm laus shes. . TRIO
” . - a

re wl
rs Tusase

rhey

oe exo-tarena TEST, ONTS

oe Ne
recie Mey

tart torte A?

| noose od rior to Lipeese Address

Hie te yor Prividaire Phens 2 | Lt Paya 9, Chie
eA TH gio Unemployed :
riAa ee an Granta bts -
i bnems leyed eo cee ee ee

ton, yhto

van Rae Sardena, Re Re it

Bneris loyed = og
_Hattoncd Peanut Coumef\ a ata 4 aetene Birgte Bidtges de ee

med ie rdena

is
paiety

“REEL
ro oF

i —_

ne

TOR RETORS KY

Deu oh

Varaunnet MPs ere
Chiles af she nero tary
leparior& of the invertor
Seaasinttan Fs, oe Ce

eae 0 ee res meme nen mem

10 Tut.

ANE CARA SRE A NA Se NRE ROA tat nn

SLE Mend FOS Marcrs ON CASLS WIGS Gast ar Ng GRATIOT OILED
3

ters

14-0000

a, FIOPOLED Position ORGANI CATIONAL DESI GwaTion,

tlon, pursuant to Chanter €2 of the Fejeral Personnel Manual.
tory information regorting this person's foyalty. -

employed by another agency and you heve determined from the losing agency thot the appointees

or lacumbent check has been completed,

working days after the appointee enters on duty (1) application, (2) file eoveriag any ine
vestigation of inquiry ennducted by your agency on 4 preappointment basis, and (3) Standard
Form 87 (fingerprint chart) unteas fingerprint search hoe already, been mete aa shoe by iten

5A below,

vidted on the back for your convenience.
sary to transmit forms in this case.

. "eo,

UNITED STATES & . SLRVICL COMAISS 10d
ora g. CIVIL SERVICE RECTOR :
ty TLOUNG *R® oy mee

TEMPOHARY gu
ard & JEFFS"

aust 1ET BREAD INTENT LOYALTY cHecK =»-s HAR 15 1951
PRELIMINARY REPORT OF CLEARANCE ON INITIAL CHECKS gin,

PERSONAL

308 DRIVE, 8. ¥. wide

Personnel Officer
Cffico of the Secty
Dept. of the Interior ~ 7° ‘lo. - AND

wache 25, Die
CONFIDENTIAL

AND PLACE OF FMPLOTMENT

Preappointment toyal ty check hos been mde on the stove applicant for a ‘sensitive’ posi-
- This check revealed no cderogay

No further pavers are required if the Proposed action is the appointment of « person

For any nother type of appointment action, please subtit to this'office within thres

SEARCH WAS BEEM COMPLETES 45 PAT! OF THE POFOFFOINT REST LOThiSe CHECK,

FIMSPAPAINTS WERE NOT SusmhTTEDS AS Pal OF THE PREAPPZ INTO CeT LOFALTY Cofcr.

a,

G. FIMGCRPAINTS WERE UNCLASSTFUASLES YOU WAY EITHER Gf) weed Tet aPoDeBTwEAT aT ONCE and SIOU? WANTS
WEIN IME GTMER BEOUIREO FAPEAS, BR CTI BU TMMOLO GPPSIR Saray 380 Seow PEraIaTS SFPaSaTT Ue TAU COWPRLE~'
T1OM OF FINGLAPQINT SEARCA BEFORE YOY DECIOR UMEIR ES $5 sFPoias, .

UNCLASSUTIABLE FEastApayRts () ame atracned, .
(7 omret oe ronwancec we veceeor fag ua CEmtdaL OFFICE, ’

Plears use the copy of this notices for your trenemittel or reply. Gpece has been pro-
a reply ia required, ever though it may Ht be neces:

REGIONAL DIRECTOR

cones ag

mS aeBdee ives

Rar repar ree: stromans reer sserreresanenernevten nine |

14-0000

poo os, o_
aT,
re
To: DIRECTOR, U. S. CHEVIL SERVICE RCOTON . /, U
. 1. Porme ottoched as tequested, Proposed personnes sation olfected Apri yas a LA _
a lorme otle 1 $4,995 ;
. 4

2. Forma not crits 8 ted becouse proposed personnes action dropped from consideration,

3. Forms noe suber tted becouse thie ie an eppointaent ei thout break In service of a person who ves
employed hy snother agency and it hee been d-terpined from the Officiel Personnel Polder ef the
losing agency that the appointee of incumbent check has been coapl eted.

- Reprints cn Stesderd Pora 8? atteched, Decision regarding appointaent will not be asde oneal the
seoults of the FBI fingerprint search have been received. .

REMARKS:

Yorne $7 and &7 attached, ©: |

TITHE WTA BCL wie Whe
april 9, 195k |. (Sis) fa. Sh00H | Poreonnel C27 tfer,

een én
SCTStiry

pxltven@esetaesde BS : Dept. of Int Lor


14-0000

wet

Fee tl nae eater renee te eee

3:

oe

- on _
‘ BOUNCY ANG ADDRESS (Str, cite, and tilt)
TIONAL POSH HO. ™
owe wracce mt . Miss kuthilda C. devrer
(rar enapts CoC PURM HR - Return thin | Chief, Administrative Branch

INQUIRY AS TO AVAILABILITY "7 | Soreclen Or pore
: a . ; Washington 5.

Jan. 30, 1551

. Ponnon
Statistical

Mise Charlotte L. Zehrung Draftsman

San Rae Gardens, RR12 iocartom
Payton 9, Ohio ; Washington, 3. C.
: TH OF ArowTeerr, «= Indefinite

«Pesce correct address tf Uiforent from above; OO prosanione,
C2 tamponany rom aascnsssecsosersscceecoess

This office is considering you among others for the empinyment described. Please fill out the “Avuilebitity Statement”
below, indicoting whether You would accept this position if offered, ond return the entire sheer ts this office, Appointment
would be subject to the Civit Service sequirements described on the back of this letter. WhetSer yor are available or net,

please reply within sevaveczoctros escoreas days in ordes that one of those who are available may Se selected as promptly as pos:

sible‘to fill-the vacancy.
Poilure to reply to this inquiry will reault In the removal of your name from the register aff dligibies until sich time as

you request restoration and furnish the information asked for in the statement below.
TH19 13 A LETTER OF INQUIRY AND NOT AN OPF2R OF EMPLOYMENT. [fsefiscted, you will be notified

end given further instructions,
Other information: -

ce

C.,

Chief, ajnin.. Branch

. | ; : _ “tex Sincerely aura, =

AVAILABILITY STATEMENT

g PY ora Avaiistle and wish to be considered for the position T.. ibed above, Ecan report fev durty within AO

days after notification, Tam now employed by -, iH a .
yet. Lorie... red 7 a 727/n

dene mee nem en ncenercanearvmareasneennsnsceanne. ae AS
; Y OD t do sat wish wo be Sonsidered for thé positian described above. 7 am “giving my reasams on the other side of

thie form.
i (0 I request that my name be removed from the active list of eligibies until I report that [ am aeniinble for appointment.
z Gr Cuasides me available for other appointments, subject to the foilowing conditions:
F| The position must pag at tcaat $. oe, QB... per 2287 NN cece Cleary raqarck. fay. oF hour).
7 tn Washington, D.C; () Anywhere in the D. &: (] Queméc cae U.

-
1 om wilting to work:

J will eecept appointment in the following locations oniy:

(24 no 13 months,

1 will a accept short: teem appointment fet: o i tod reeathe: oO3 3e to 66 manthe:

. 2 ;

Babe AI8Sb eee i RO ae
{iet8) ™ " : at 2)
nena

14-0000

te

oy

CER AOU hoe. eaters ene o

Saab ely heeds atte

eee BAR ALE 8

Sheat6, REA DAET ER MERA IS, “RR NR ELE 8

‘
Pe ee 2 ee en

as ae ‘ :

branoarD ror 78 ~\ 2D STATES CIVIL SERVICE COMMISSION
FEOr RAL RCWSONNEL CERTIFICATE OF MEDICAL EXAMINATION

MANUAL CHATTER Ml

(Applicant must supply information below to heavy line)
- Oypewrite, of Print ia Tak)

1. Ma, * (rast KAME) (MIDALL RITIAL) = QASTD
Ma Ula rlotte Lh. Sehrun;
PAVORISS TS Tis OF Foshan

gan lie ut. rUulu, Ayton J, Vue Statistioul Draftsman’.

TFARTMENT OF buRt ay Ty WHICH YOU ARE T Oe tai

ice o hh ecre

Interior - cries of boos raph

0. ARE YOU NOW LNPLOYLD IN THE POSITION SHOWN Itt iTUM 5? [1] YES [NO
THiG POSTION: .

8. A) RAVE VOU ANY PHYSICAL DEFECT OR DISABILITY WHATSOEVERT ves hl NO. UF YOUR ANSWLA IS “YES,” GIVE DETAILS: i

Rashington, De Ce
TF YOUR ANSWER IS “YES” GIVE THE CATE OF YOUR ORIGINAL APPOINTMENT TO 00+ .

. 1

(%) OOES'THE VETERANS ADMINISTRATION RECOGNIZE SERVICE.CONNECTED DISABILITY AN YOUR CASE? oO Yes Q: No °
(C) HAVE YOU EVER: nEcciveo' DISABILITY RETIREMENT FROM THE U S. CIVIL SERVICE COMMISSION? o VES | - to, 7 Tg a

Sign your name in INK as it. eppeare aan appli-] SIGNATURE OF eee - ee _
edition In: the nce of the physician .
x. - Loe a

of ‘identificatto

cation Placement Recard
‘Before beginning ihe examination refer to items 9 and 10'on the Health Qualification Placement Record eo that you
Sign beth this certificate

DOCTOR: All qhestione on both sides of iia, certificate and on the lower half of the attached Health Qu:

must be answered,
will have kiiowledge of the physical requircments of the position to which the applicant is to be appointed.

ond the Health Qualification Placement Record,

1 HEIGHT: FECT incuce WIGHT "se. POUNDS.

Levee >» a 7»
"Gy DISTANT VISION (GNELLEN): WITHOUT GLASSES: RIGHT/:+ LEFT 2° ¢ WITH GLASSES, IF WORM: RIGHT : 5 LEFTS.O
(D) WHAT IS TE LONGEST AND SHORTEST DISTANCE AT WHICH THE FOLLOWING SPECIMEN OF JAEGER NO. 2 TYPE CAN BE READ BY THE APPLICANT? TEST -

LACH EVE SEPARATELY,

WITHOUT GLASSES: WITH GLASSES, IF USCD:
employes in tho Fedorol classified rervica.ot may be, roqurated . , “or - -
by tho CIs2t Service Cotminkalun of tte authorined reptracntative. Ze oN 28 ow
‘Ans anter wil supplement the Eeocutive Orders of Moy 20 ond R WN. TO so Ro IN. TO
Just 18, 190) (Evecuth 0 Order, Buptemter 4, 1924). , y- a.
: ‘ bot. in. Ton. LZ INTO IH, : .
RIGHT. nen nee LEFT. —-~ a

i! EVIGENCE OF DISEASE OR INJURY:
“(h) thy COLBR VISION: 1S COUOR VISION HORMAL WHEN ISHIHARA CR DERERCULOR PLACE, Test ¥5 USED? 7m YES Oo no

I NOY, CAN APHLICANT PASS LANTERN, YARN OR OTHER COMPARARLE TEST? Oy YFs ry NO
4, FAIC. (CONSIOER DENOMINATORS. INDICATED HERE AS NORMAL, RECORD AS NUMESATORS THE GREATEST DISTANCE HEARD) ORDINARY CONVERSATION:

RIGHT BARE EFT EAR del 2 EVIDENCE OF DISEASE OR INJURY: RIGHT EAR Zaanem. LEFT EAR Sh *

& MOUTH AND THROAT

% PARA WASAL SINUSES

7. GASTROINTESTINAL (A) HISTORY OF PEPTIC ULCER: () YES [x] MQ. IF "VES" IS ULCER: a pares Q QUIESCENT (2) neacep

; Hoy LONG? DATE OF LAST X-RAY, : ,
SYMPTOMS PRESENT, 1 ANY (Serecity, frequence. eta): a
TREATMENT (Use apeco under “Remarks” if cxedwd): .

‘ peepee ee

Oe eee

@ HETABCLIC MISOHOLAS (NDICATE ANY ABRORMALSTY OF THE FOLLOAING GLANDS BY A CHECK 11 THE APPROPIUATE GON, ASD EXPLAIN UNDER “REMARRS“),
( nrrvroo {[] pancazas £7) perutrary (J ovarian

10—25804-2

14-0000

| 4 DEFORMITIES, ATROPHIES, AND OTHER ABNORMALITIES, DISEASE NOT INCLUDED ABOVE

a ) IF ORGANIC HEART DISEAGE 15 PRECANT, is ey Contr?
GD) SH ORGANIC HEART DSTASE PRESENT? §=[J ves [kK] no Cvs (xo
Dp PULEL RATE. 1o * mas
SITTING 2 ___ IMMEDIATELY AFTER EXERCISE (UNLESS CONTRAINDICATED) — i So

TWO MINUTES AFTER xt ACISE en CARDIAC RESCAVE
{GO00, FAIA, OR POOR)
10. LUNGS.
“Recut Peper err teen -

SRSTORY OF TUBERCULOSIS? Ov (KJ Na. UF “YES.” HOW LONG HAS THE DISTASE BEL ARRESTED?

OF THERE (5 HIT LORY OF TUBERCULOSIS. 1S ANY TYPE OF COLLAPSE THERAPY BONG RECLIVED AT present? ([] yes [[] MO. iF “VES.” GIVE FULL DETAILS

UNDER “REMARKS.” 1S MECACAL SUPLAVISION NECESSARY? [] Yes [] NO
OF X-RSY 1S MADE, GIVE REPORT UNDER "REMARKS."
WL HERMA: [J VES [R) NO. IF “YES,” NAME VARIETY: INGUINAL, VLNTRAL, FEMORAL, FOST-OPLRATIVE, ETC.

If PRESENT, 15 IT SUPPORTED BY A WELL-FITTING TRUSS? [] YES [7] NO
RR VARICOSE Vises: (T] YES ENO. UF “VES.” STATE LOCATION AND DUGREE “

ame memset tine ban eter en

12. FEET: 15 FLAT FOOT PRESENT? [] YES [09 NO. AF “YES.” STATE DEGREE OF IMPAIRMENT OF FUNCTION GRE GAT MODERATE SERED

Fone ~

18. SCARS OF SERIOUS IRJURY OR DISEASE «_

—_ 7 ? G-120 el x .
18, NERVOUS SYSTEM: (A) INCLUDE SYMPTOMS ANO FULL HISTORY OF ANY MENTAL, NERVOUS, OR EMOTIONAL ABNORMALITY (U3E ADDITIONAL SHEETS IF NECES-

sO prorie .

GD HAS APPLECANTT EVER BEEN HOSPITALIZED OR TREATED FOR A MENTAL ILLNESS? Cves io
£6) WHERE QLAME AND LOCATION OF HOSPITAL:

® pareor DATES OF HOSPITALIZATION:

© DESCRIBE ANY RESIDUALS OF PREVIOUS MENTAL OR NERVOUS ILLNESS; : . .

COR ORD MARYS BELG
ONG ARL MALL, Civ OLTAILS UNDER “REMARKS,”

Huis? [J yis [Kp so. IF SO, GIVE DETAILS

(FY ART MITTORY CF EPILIE TY O9 FAIK
PAGLOGY OR OTHER LARD PATORY | CASINAT

17. ENVIDUHLE Of% HieOR f OF VEnLFEAL CIODLASE IF BLOOD St

Ai Oke . :

NAME TYFLD OR FHUIXTED DATE

i
|

1

j

18, URINALYSIS UF INDICATED):

: £7.62. soem ALBUMEN ee TAIGAR —
| CASTS BLOOD AAG ~ ~
i ] HAVE FOUND THE FPHUCANT ABRORMAL UNDER THE FOLLOWING HEADINGS:

Po

: 7

| |
| -
H REMADE: :
H _ £ -

i Loos phegastol sense’ Letet Novena’ BERLE of : thease

j eee

iy

}

19 SIGNATUPS OF PHISICIAM OR EXAMINER ~
é
Albert F, Kuhl, M.D, | 2/8/52

at 00 YR a F . ot 3 Ton
FON TipgECtAAL CisiehArion) Chives i} xo

x ' Niattal

9. ADGHLSS OF ERAMINING Prvcaciall (Ty ped ar painted)

: 916 Harries Bidg, Dayton 2, Ohio

fj fou. tows


14-0000

a Mom dna att de pane

ety

bate aed

seme Se

Ane tere cones Nn wet tema SAAN gah hatte Adin dtnabinednen AE ms Vtivedl nes sm

7 . a Coe a Se

~

okey am

\ HEALTH QUALIFICATION PLACEMENT RECORD

(This section fs comparable to Standard Form 90 promulgated March 1945 dy Burcau of the Budget Circular A-24)

Quast)

(MzaT MANE)
ess SUNG

Qa bald at
MRS Gis Pautte Tt

& TLECF RONTION
Statistical Draftsman
7 LOCATION

whio

Stu ate GUraucnu, wey TOR go,

& DEPARTMENT OR BUR: HICH YQU 10 Le. tary
CENCE EP pr reeerae

InterSor = vision of Geo Tashington, De Cy
@& ARE VOU NOW LMPLOYED IN THE POSITION Ee eae 3 YS tw, UF YOUR ANSAER 53° YL" GIVE THE DATE OF YOUR ORIGINAL APPOINTMENT TO

THIS POSITION: .

TO BE COMPLETED BY APPOINTING OFFICER: Sechoas 9 and 10

Uy BRIE OUTUNE OF WHAT WORKLE DOES (h PHYSICAL OLMANDE OF THE POSITION
eet dows in brief and sicnpte terme what the employee | In Section 10 below eocircie the fumber of those factora which are qasential to
biolives oa tha nctons eavironmental details sch og steire to climb, dataoce | the dutice of the rexition fur which thie epplicant le belng considered, The biank
to rest-roo ties, cafeteria, wosk-shitt, etc, (Vee Sectiun # below.) tpaces may de uae foe epecial facture not Hated.

& TITLE OF POSITION AND CUTUAE OF WHAT WORKER DOCS 1M TH13 PUZITION (eidtien nt of dictionery of orvupefsoedl (fica €s Guide, 0s epplicasia)

.

Statistical Draftsman - To assist in the performnce of drafting, lettering
and incidental statistical clerical work in the preparation and revision

of index zaps, showing the location of approved and disapproved nazes and
the extent of features to which nanes apply; charts, graphs and other
illustrative materials in connection with the functions of the Research

Branch.and for administrative purposes. .

aos WA TART TE nd 1S

relating ta physival re qa reruents act encircled o# nct covers! by this focus, Inticate
theee under “Remarta on Ue teverse suie. Whenever PAI TIAL capacity has
heen Indleated, eapioa uadee “Remarks,” giving epee quant ting

TO SE COMPLETED 87 EXAMINING FAYSICI

INSTRUCTIONS The lees as led ‘I Beta indicate the pliydent repurements of
the pee ton for wh thie bet vidual ;

PAY GSA capaitice for thie peartic +
eppeenis the aunibersencemte Er

PHYSICAL aan

ES

as — Ervin mcnTat FACTORS
° CAPACITY ~ earaciry
_—— aS FaRThal oA a a. ee
+ CUESITE ~ Ey 18 vee] AROUD MACUNTRY win NQATND Pears

28 Benet OA ETS 2

3 CUTDIDE AND INSIDE

DCVCESsIvE tal == [cB WORKING CN LADDERS BF SCUTOLOING
a& EXCSSS7 Cro cis WOUND BPLOW GROUE
TEE UMSUAL FATIg“uS FACTOAS (Spee¥y)

VF HGMINTY

ORR WITH MARDS IY MATER

PLC ES

oh VIGAATION

Dh WORRIT CLOSELY OTH OTR

2B cues rant Nome

wr rat

mh ProTUcrdD 0 On TRROgLAAA word OF noe K

Wn Erica FACTURI {Sper at


14-0000

a
: ae, PN

Benin. seautte comarssten Ab. awwATION FOR FEDERAL EMPLOYME...

US CIVIL SOR VICE COMMESS HOM
INSTEUCTIONS In tader tu trevent deloy in ronsnieretion youre appl. the atmremen card Faas, Aieposition of thie application.
cath, anewes every Questia tn tee form clearly and compictely, Type fot an UNWEITTER eeaminstion, me thie nvlic ative

rent in INK Fee orev a ayeriie United States Greil Service inthe annvumsement Re eure to mail tot
tired by the ennnumement. Notify the office eH onc

ton, read the esamene' munrement ¢
eI you are tying Cr rs WRITTEN oper met any change ot yout wAde

Kab OF TXAM INATNA A RIND OF PUSITION APPLIED
OO MOT WRITE IM THIS BLOCK

“pbs tpl LL EGE j Dpiht apege _+ et Uso oh Ch Service Comainsicn Only -

NAT OF TaN UERT oO TON (City and State! DATE OF Thad APPLICATION
Ye chipe Le a Fef RTE
ee. wet hame, Ward > eny,
ead :
mss acfoth a Loe ls é cf, L Ciel al
it Cher fern cn 5. wumpen ( 4, BY
APPROVED: . :
pen Jee “Gite rr aens BS gig ele wai A ortiom onan a mares. | avon,
‘ Da OH. Ohio ‘ oT -
—] 5 Rolie BE RAME (State) 0 WA OFFICK PHONE | «Oy MOUL Prom G. th dbd. coasene
; “
oo hio secant cneanseee ecko fn ENC) poy nese
| VATE OF wats  Gaonthe lay, year) o. waapen, 29 2h _ "
; anata | ssesansereaveacncece| enearesee|eeeerencee OF Posease-
—_ pri PLACE OF ag fa fahy and’ & honmn feta, outside U 4, name city and country) oO nt
aL Day. Ob rai Ohio __ : - - : org, .
wey. GP heat wirwouy SHOES: WRIGHT, ~ peorecsnrenneenscereceevcereree|esrescoreel J INVES. | sonmnnny
Ar a A nk, Oe en nn nn Se
16 Gy RAVE YOU EVER OTL EMPLOYED OY THE FELTHAL GOVRANUENTT oO ves no . eter ;
pate

(If SO, Give LAST GRADE AND DATE OF LAST CHANGE Ih GRADE
$18 5

(Or CHECK IF YOU WILL ACCEPT AFFRONT MEST, LF OFFERED:
(Hm wastinaron, 0.¢.  C) asrwnice in rHe caren scares

1S wo war! 19 THE LOWEST EATRAMCE SALARY YOU Witt ACCEPT § n

PER YI
tou ‘wali not be considered fos any position with @ lower entrance
ealary * °
1D) CHECK IF YOU WILL ACCEPT O07 TERM APPOINTMENT IF OFFEAED, FOR QO OUTTIOE THE UNITE STATES
(31103 wonres (5 16 ¢ counts D6 10 12 monies HRD AF YOU WILL, ACCKET APPOMNTMEMT 1M C7THIN LOCATIONS OMLY, GIVE ACCEPTARLL

NOTE. Acceptince of refusal of a bene orary ahatttse ms apmnatinent
will not atest puus opputunsty (a oblacn @ probational oppuntiavend

60) IF You ARE WILLING To TRA SEL, SHEE
_ he] SE CAD AL

ates ;

OC cousr, TABTLY eel
ere a a th pene

4 Exrenirnce It ie unpestant toe yoru ts furuuh ell, all information requested fetigous, stvle, waltare, OF ofgaditellceat wnvity whith you hove performed,
below in auihoent detail to guatde the Cork fells ‘@ Commisiug and the either, fe witliout cunipensation, abewing the umber cf lanes per week
appointing otters of agence wr ghee you full credit in determining your and ie iy whith vita were engaged Ja auch acttvily, MUjtasy
Queliications. Use im orporate bine ach beatin. Star ye q your Snyectlenre ayes Letdeeribed 19 the spaces below in ite propes ecquence,+

ent position ond work bere, a4 chew principal taike white , ed
Pee performed in euch pontine, acciousitissg fot af! penods of unemployment, ata {ro siren Spiiteved im any pom sal unter ry bre, (itferent tessa
ogo which 16 Gol pertnent ty the work irk” for exh porition, the nane pend,

snared in one of mere of the blucks,
use (oy Af pou have never bern srophived of ose now unemployed, indicate

CY ae space provided belew for “Prestat Hestian.~

: h you are appiying mas
MM your dutica changed muatanaiizy ertnie wasting tor the some employes,
You may coclile any pertincrt that act

a wpaaste Dhak to describe ear fi poerven.
PRESENT POSITION ’
“DANS OF UML EAT Cicntns ready STILE Uv Your FaesenT ouTON ELAS VeaaGe OF] SHAR C# EARNIAGS,
| in Federal Sarvice) 2 pa
pra

FROM tO POESENT The

~ Ser Sora eartatbor a = a
PLACE GF EMPLOYYEN! (arty ead Stato}

eee
Wud ANS Tite GF

“Raut ang AG BF ERIN (Ame, orkanasetion, Of peeron, if Pedecal, | KiNG OF DAINISS Ol CAGANIEATICN (a @) whalee
name dopar(mont, Duseau Us assablatoant, and divison) manulacture ut loose, ato)

aulh, snsarence egencp,

> “TRAGOA TOM MGSINS 10 Craned CAe Mea

BWUMEER ARD WIND CF EWALS VES Bn esa BF FOU

Baer OF pov KSAT

(CONTINUED ON MENT PAN?

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sete retin at emmerene tn

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ae

7h CONTINUED
@ DATES OF UNOI SENT (me enil, pene) “RR ing oF 02 SE a TOW GRADE ROS UA ARG
yp | | (len Federal pervece)! creations § pen

reli ten expt ee |

— eb eele eae MD ren
net ow BMGs en x Nie aN Sea We THN OIATE SCP IECR

ye s Y
oh for ue ‘oN é Oe, SS & ) f o
Met Dey tee EASES Give san ike 9 ere Cocpuinee: “coal fO (ae. adele ies Anis...
mane, ane irreron) Reanutacture uf Awas, ote.)

Iva chechnieé

Ja R .
_ ans 6a re ASEHen gs- Dayton, “ASN mn EE.
a

oe char bo. -

seb ne een ene eden ce canted anneseenmassannnvecm ens]

DATES OF LAFLOYREAT Conunth GAACT TITLE OF TO. ARO CLASSIFICATION GRADE SALARY OR EARNINGS: © -
\ Ulin Fadoraleervice}! syantina gs Ct
. PN og van

RAW RNS TITLE OF IMMECIATE SUPERVISOR

me iene, us Bsr

Phia._.. Ei qidaire_| mF ATEN To G re NERDS TET Tnsavaoe adem

“WANE ayer OF TMA OT (nem, ofdan a, OF qiss
‘nate department, Bureau or estabimamont, and division) aeanutectuce of dicks, are.)

Frieideire _- Payton -O, | menu factuce of Frigidabras

NUNURITAND KIND OF EMPLOTIL SEG ber vou REASON FOR LAIN

16 Ss Betta mto acheal_—__——

“DESCRIFTION NF PNA WORK

serleed
warlee

te Ry iran ae

Ke GATES OF LMALOTAINY Granian, year. TXACT TILE Ge TOUA
seo ae ‘

veg instation, af person, Wt Festet ah ee aS <5 OR QIGAMGATICN (> gf, Whaleas’s oh, tnburance agency,

aay ‘$
“game “Uopattmont. bureauor establishment, amd Crenand soatatartuse of fowaa, ofc )

Thay ITA TION GRADE Saad Se EARNL
Gti Fodoralsorviea)| szasting § ea
FNL t mA

Sf NUTRATE surFaVigdA |

BSXCRF IR OF WOR WORK

L


14-0000

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_ - An. VU 233. MAY E58

2601-10 Mex, HW.

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us PD !
MAY 10 i959 "- 0 2. :
ape °

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ah gta meee ent ?

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i Hoary Cn ith. hiatdis «0 C30,
i 2. Mhawt. OR hen Jaen irae tae
i . Late Oo oe a ae aawrs - ponte. PA mee, ae
i wy eee c pl ee Sree hia apc aad
i ALi ata ree CE i 2 ete - Lt at ene Ad or
} nt EO ada TP iteey on Nseate a abet vent y
eet! el earths | ae
. CHE wee. ae wel oes “peti S
t eT OY ok.
PO Seer ~ a he, 7.42.
re Che CU hea Lovse + ot Lot ya.a) ea

af --.

f eae .

f ei, aa ela areead eee
a ° but ate Tiitte Akt hualoten? vine!

“
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“ we

film tee Cele oe
7 ’

Be
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AE RAR ker sting oa

preere

ca heen ne wr ma UNOS ERIE PURO yan wt

v . . _— . ao .
: UN..tu STATES CIVIL SERVICE COMMISS:ON
r RATING SHEET—RATING PROCEDURE NO, III.

(Handbook %-105)

d

NAME OF APPLICANT PREFERENCE APPLICATION NO, .
. (tor.
. +. .
id Ke 2. ? ! c
oS.

QUALIFYING EXPERIENCE

BASIC RATING
c Z| aopirionas points

a 7 f CARNED RATING

VETERANS PREFERENCE

VETERANS’ PREFERENCE
FINAL RATING : FINAL RATING

DOMINER DAT ‘Daminer

: : , of “3 yr
MB (ue SAB SO Roe |

J a ote

REVIEWER DATE REVIEWER DATE
| COMMENTS: _

Pou tion Te ~ TOSHIGN TITLE

ANNOUNCEMENT NO. ~— "QUALIFYING EXPERIENCE | ANNOUNCEMENT NO, ~

GRADE
BASIC RATING BASIE RATING” .

AGDITIONAL POINTS

nt On ie pene

ADDITIONAL POINTS:

FARRED RATING EARNED RATING ’
VETERANS PROFERENCE . VETERANS’ PREFERENCE

ee re — ot een ee
FIGAL RATING 7 FINAL RATING

pain = SO”S”C*”~”~< aTESSSSC~“~*~*s~s‘“‘s*”:* RAE DATE

BRET igo cae - SATE —.

COMMENTS

ener nner errno teres rasenemnnreatntete trae ne menananee renner
Mam treat cst ror 4909
meAY bE


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+ on eet ae mee,

ne ERIM ranma @nete SOR Oo:
a

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/

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+. Z a Pagrmrtret,
Oncles..

, A :
/ oot YF tnt Ha Lowe Portcis Be veks
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io

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te ff, é eC
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14-0000

a

-_ ON

Bere cegeereet
wreau Rusber 6O-RU50)

Toem 18

Fetewary 196 ‘ UNIED STATES CIVIL SERVICE COMMISSION Dated
PROOF OF RESIDENCE |.

eaters bead on vedines deailanee in the LAote of Tort
fyprent in the ape aticnd detertnentsl wrvie tie
tek Father ber eubmit this bem, properly eaccuterd,
prdiccinte whe now held permanent foations in the opoutioned
wrete ue HW Am in the ubgeath nad eviee

Alsticotions for apgeintment be the ap pettionas deqortnental encvine mud be deem
tery ceria bre of bepet one your neal preceriites tha dite of make Thee of
Ritwereg quecime seat ta ne

lot Opieantinent in the aitertinad prrvice +

esth pout epdesation emp teeait In bees ud cmet!
deiattnenatal aorvine gra md tequlted ty hyve the Oiler « ('achieite of keeutene wtecutarl 16d eens

From.# ct 1%. 19. ee we Feb. 19,
Arnish) hi

reader Tan aay ie puch
My 8, of ote living

wud the oorory, Extent you ha Not revidet cunt 1 - Stu tory in which chris woul
4a farina pas ne Pieces eo te on Toon ain wich yes berysh on piesg
a iH

age, {ul in the ‘bain Honke
, guardian oy Lewgth of euch tesitunce

CHE OF OWN occ. ceeecserrscrnssvceresscegracoansce

State he a soiee in thai Sealed Gee “MS From. snee ih eaae 10% ones aggcases <Page

CONT cernessnenscerces BOW nenencrorernsorsene

age We emer ngecsoeoe

tis) ai

From... ats pereee MY.
ard)

County veer enensecscnssmseeanncenancetemaasannss

Mashar

are a morriad women, th in the fullswing _
‘waniloge ngih of auch remdence

PoMeecenieneg ieee Wares WO resect renene ~
diaiaae 3) tit Wena Cri

* HONG oe eaten n reese geet ger eerngeneeceea es eeerer
Ia he a voter in thai Shute" ¥en” GAs

Frit .esen sa seeee 3D.
(Month)

County co.cc scser rar coeesneeceneeeescaneaserere

IURAT (OR OATH)

Waters “try medi Meth adeniningte ot Aor Aber Qulbortsed ws odin: ie

This feret for sath) must ba ovacuted bafara anv tary pubs tha ror etery ota Uiiteg 2
fer outle fer youre ga ye eo before wher the applicant nual upeue $0 pereon.

ertyce L DO SOLEMNLY Siu Ae Oi AFFIRM) uot the stutemeuts made by ine in anewss 9 9 trojoueg quoctiens are tull ar true to the best do my

Lata
Signature of on! Ne teres. Chadabd Lie 6: & ws

Voth
hrcwlecdge:

“ad if tparried, ure

fh teaala, proba!

ony .

ope nettttingy ws tee the be mupauenete
oper d hme LP OBI crermenesen bocce vere Ord

. MEYCAR aed et Vege 1. .
- SeclaND, aye
“wy CORI CLEIRTS Maal Eh,

OFFICER'S CERTIFICATE OF RESIDENCE
Saatructlone —-if the applicants clint ts i meee! om legal . we orrdaty publie, counts, turiciial ot police arsant cterk,
mayor, fuancs of (he peace, oF uthee oMiees in lg county Geary in Mate ee the app eT sad on voting fesstemner alone, thw y
must be erecutad hy te pe petrar of soters of cher dic tha Deir of Bley tune ® aighaal prdect and othasr in the cr of
ehainiod G9 the apes hon) the cothhonta must tae bia official seal, stud therent, corthosnen of tte Abel Shot nuter by lho ptoper uiwer utnt otfietal seal.
The applicant ls not required 19 aoppens in person before the officer who osecutas this certeflecte, bot the othoog should sutiaty tuseait irom crekote and

competent ovtcnce as ty hicts to which be cartes,

La....NoLa a
eet anger

do hereby rertly that .

te now ae Legal:

ee
Dated at anh. Garrollton.

[OFFICIAL SEALE

_ of the ounty dt . hONLBOMALY......... ard taste 9 Terntcey) of QUA eee -
seas + Le. Zahrui eeeecee, the Opphoant whe ecamts 10 0070 entation with @ civil cervics examueraton,
Meee Tee ade: act LT as hve t tot .

omen rot eral hecnyd . MOM EZOMECY, veeeedeeneeeese - and Slate les Terntory)

Pex Leto
) :
nt hoa bean soc ruttent for Bs months fast preceding tha date here

. coun ot. Montgomery.
aaweeserceusenmarewcsscsecers BIS .wSth. day ot.

My comminaion exires July-Ig=rg5e" 3 sgl i Y for arenes sre

PS esanuse os conection te mate tn He “Ollicer’s Cart. tents,” casniteation tual be mode on margin bythe alten |

Tha OF ficial seal misat not be omitted,
whe ertcutes the certiiivate, showing such casection.

8. Rospanmant raynriye rece 16-—T8-T

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EARNINGS BEFCRE.A

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INDEX OF

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CABS ee Ge TAP OR CARIES
Ul in Federale vo) | aianting § wn
toma, an

hac, THe OF YOUN AUS TO

ft ni we *
| RAME AND TLE OF IM UTAATE wPVLON

cay an ana
OVER (Beet, re fan
Pace departnent, busesu of eal sbireher

penn. if Federal,
reseron)

RIND OF BUSINESS U2 CT AISTATION Ce @ “wholocate afta, Invurence a honoy,
manulavtura of hehe, ote)

NUMDER ABD KINO ore TMPLOVERS Burt Avisel OF vou

TASCRIPTION OF YOUR WORK

50 mane epere ve Hite aed use @ continuation sheet (Btomted Porm No, s) or @ ebeet of peper the some mse as this page, Write on cach shest yous nese, moe .
eddrese, date nbbirth, and examination title, Attach to insite of this applitation. . .
i 07, UlestADy THAIMING Im the ejace helew, deartile any training rerewal in of treining toveived, each et houre eek, Detailed informatwan sogesd-
the Armed ervices (nut already heted under lem 16) that would assist ing any special sevvier wterde you attended ts tmpertasst, o
ng yo must efter tively, Bovtne : one)
ULCATION
pesevanreraseorasvconacs sss] esd eee cuesessneuntanenana nea teeesesesssareneee seen essnaerenasatsuna Sage rarcees saenenmacaesnneronmaane en :
i . ; WISHIne Settenes seen tacantnennnasasennenenueeinecanaetane siueenscausnaneenee nae
- careeweenssacse|socnssssmanccees|sacraroscsesercarserccasacascranse a+] aessesaageerncae sens ceeasarracassctsecsasconsarsseneebean bees teat as nitetenetanseeransucareneonnsnsencs cel ,
i wecedecerrse|acaeceenenacees: [ena aserersersrsctertmncerecstonesieslacesnnstsbeuetasenttententeeetasersses coer ree: weteceenerdsentenreeore: secaserececemenreece-ee
2 ‘ EOuCATOn (Cucle highvat grade curmpdaled}: (A) GIVE KAME ANU LOCATION GF LAL I BSGH SCHOOL ATENUED: .
vi 9 Fb 6 F 8 7 6 8 BH WR
i MARKO) THE APPOOPRIATE BOX.TO IMLICATE SATISO ACTER COMPLETION OF | (a) SUBIECTS STUDIED IN HIGH ECHL WICH APFLY TO PORTION DLIRED ~
i (reese ROC [Shanice we Hie! a beciaasedll CY awe Pi OOS .
i Snemmcmaanstt pens eames ne attra A Se Sen lr SRN NNN ee ttt ent oe &
> MAK { PATS ATTYNDED {bars Compterip ceanres COMFERRED MEE
A © fuue AMO LUCATION OF COLLEGE OR Un reRrati r Ann eee | atatespamaer ueperrareahl ng ey, ’
‘ Posrrnuaury | rv } 10 Peas tf oiene tb cere
monet tote ere ee pe - [-— - oo ee at Ee Hes ’
pity Cap hte’ idniter re LORE LS
“yf SEMS EL. ae eee Ln |
: Cn QGuctemala, _ ment a
‘ (a ine Yous “att a VDLATE COI Lik 4s % wee Your Cu CRAG ATE COL ADIT

i

: :- Oe beeen aed nee eden enter eetne, : 7 . | ~ sities

KE) OT ER PRINS, S64 WS VOCAL Ge LIRESt STENT ZR RES GEN
TRE AG TH ARM YD POSSE eSTOGEL Oates wets aiid beer abil
of sched OA 1 LIC CR TAINS 58 PUiLc OF PR ATE Cito eMd ne

FRM

|

OM CEE US BIRD ANP PERCE ET
one wh feuen fat pot, eieetrieiaa tadvas Gparatur, toashar, lawser, CPA, e186 A

SARA URL mares

tM GMIATATE for ore a
PRES Lament

Cc Ww a ~~ ery au

PUT LEE OG Chita Ty eet ey

31S h oe
feo eas

SFE Ta hk BB AGE Pee tee
CME oS 4.)QTES AMD Lites fan o> eT ee
(sy werner at Fuses to gy cubters carei-a, Latinas, educa
Gh, Gocren tiny

VAC AVES = I~no -tetreatian

Qrwcetcen al doer id cho

rE, FAM MAC OR FZ BLT TEAL

OF LICENCE ARO STATES .

ECA UMTS OTE Crh

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APT ee are em
Un > EN
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Ae PRreATY Nites aE BORO FIR EO ILES Tenn PP yemetenng

Loney


14-0000

Litt heme teres fiving in the Unitet States on Territories of the Urted Biates who are NOT related tr vou and wha have definite mnerwiedge of
Di not repeat names of supersisces hited under Hem 16 (EX PR RIENCE).

ees
Jet Gan SN eCoes aml Ataeee far The position foe whch you are eppinng

- ~rolamane - | (Gere comple Gj otroet and aymber) | OF 2"T Ss OM OCCUPATION _

Mc Hacey..Schioacta > Remracy A

An x sa TheedesiaClonan. | Caxzanovi. en | EL CE © Sid SR

ine _erbert Hauldeonent. Hh lian bn: ; “be
38 apr you an W OFFICIAL OR EMFLOXLL OF ANY STATE Teemitowr county. | |

waMcaTE “VES™ GR “RO ANSALA OF PLACING TE" IN PROPER COLUMN
Nee eee
OR MUNICIPALITY? ........ sao grntmmenene cae ”
ive dotaiia in item 39

Uf your onewer fo ¥e:

6 DOS THE UNITED STATES GOVERNMENT EMPLOY IM & CITLIEN CAPACITY
ANY RULATIVE OF YOURS (AY P1000 OR MARAAGE) WITH WHOM TU LIVE
OF HAVE LIVED WIT WIN [HE PAST 26 MONTHS? . ae ae
Hf your anewer ta Yea” adow in Item such

ve (i) full name; (2) preaent add: Gg tonehip; ”
rement or Afeoncy dy which omploy Land (5) ken’ -

ni men

SPECIAL INSTRUCTIONS FOR CLAIMING VETERAN PREFERENCE

A. If you are claiming preference os » PEACE TIME VETEMAN who has
bern awarded @ campaign badge ee, fe service tibhon, of as #@ DISABLED VET.
ERAN, of as the WI rx OF A DISANLED VETERAN, re 96 te WIDOW OF
A_WAR OR CAMPAION VETERAN: | piteck Veteran Preference Claim,

CSC Form 14, together wii Pa Mtead 4 therein.
8. If you are a WAR. rein RUE: AN mot claiming 4tsatdlity fex ence,
ww, ‘should NOT eubmit your diecharge with this eprtication, Preference will
bail

tative! wel. credited to you and if anponted, you will be fequited ' ‘to subenit

to the iting officer prior to. '¥ of duty, offic:
hon from active service in the armed forces of the United Bestes in iene ol om

TS war y.cey Be wane OF VOUA PALSENT Ruryorme eraanorys vou
CuAGIOT © SeaUCATIONS FICE we er

B pan YA & CITIZEN OF O8 DO YOU OWE ALLEGIANCE me TRE UNITE

UD_AsE ve oe 08 Mave You eve BEN, A Bee ek OF THE COMMUIOST
PARTY i SR OM ANY COMM UMIDT DRGANIZATIOND ws

2B ART KK Ee Cat OU EVER DEEN. A MEMBER OF A FASCIST ORGAN.
lute eee s

29 ARE YOK Wa OR HAVE VOU EVER BTEN A MEMSER OF ANY ORGANIZATION,
ASSOOATOR WUE MENT GAGUP ON COMBINATION OF PERWONS WHICH AD-
VOCATES "SE OCS SU OF CK CONSTITUTIONAL FORM OF GOVIRNMONT,
OR OF BR OCDANLIATION ASSOCIATION MOVEMENT GROUP OR COMBINATION
OF PES OstCt HAS ADOPTED A POLICY OF ADYOGATING OR APPROVING
TNE COW SESS OF ACTS OF FORCE OR VIOLENCE TO ONY OTHER PERSONS
THEIR RIS* TS. ROLE THE CONSTITUTION OF THE. UNITED STATES OR OF SEEK.
ING TO ALTTR Pel FORM OF GOVERNMENT OF THE UNITED STATES BY UNCON.
BTITLTIONG, WEANE?

Tyo: answer to gu
in trem SX tse naines of ali auch organisations,

motementa gtou;

27 (AD WERE YOU EVER IN THE UNITED STATES
"DURING TIME OF WART Wc.

ILITARY OR MAYAL SERVICE [F ”

membersa Gir
pati iiedshec thie ve “octlvis AD 1$ THE WORD “HONORABLE” OR THE WORD “SATISFACTCAY” UTED
- IN YOUR DISCHARGE OR SEPARATION PAPTRS TO SitOW THE T¢Pt GF YOUR |
WD SHOT WUT RIATHOAY HAVE YOU FVER BLOM ARRESTED INDICTEO DISCHAPSGE OF SEPARATIONE 2... ee cece cece _
OR Samm ND COURT AS A DEPENDANT IN 4 CRIMINAL PROCEEDING 40) WAS WAVICE PEAFORMED ON AN eres Fuu TiME BAST wre han! }
OR CORNICE MINED CR UIMPRIVONED OR PLACID OW PROBATION OF HAVE MILITARY PAY 4NO ALLOWANCES? . 1
YOU ANTR SAN CROERED TO DEPOT BAIL OR COLLATERAL FOR THE VIOLA (Oi | GATE OF ENTAY OF ENTRIES INTO SLAVICE | OATA OF SEPABATIO€ Of Ti PARATICNS

TION OF AND Law ACLICE RIGULATION OM ORDINANCE (CXCLUCING MINOR
TRAFFIC URLALIONS FOR WHICH A PINE OR FORFEITURE UF $25 OR LESS WAS
IMAOSE OT . anseetezense

it your, snoeer ) 0.’ fiat all auch oases under lism 39
below Gave in cach caen (1) the date; (2) tho nature of the
ofenas oe vecietron, (J) the name and location of the court:
(4) (he peas ty umpoacd, if any, of other diapo:
case if apswnted. your fingerprinte wilt be Faken.

AY HAVE YON, UL S PREM OSC NARUTO OF FORCED TO RESIGN, FCA ASCON-
DUCT OR UNSUPSTACTORY SEAVICE FROM ANY POSITION) ..
If your gnawer is “¥oa,"" give in [tam 39 the name and

BRANCH OF SERVICE (Army, Navy, | SERIAL NO (Cif none, r
Marino Corpse, Coast Guard, eto ) rating af tims of separation).

33 1A) JF YOU SCAVED IN THE UNITED STATES MILITARY Of MASSE OP ICE
DURING PRACETIME ONLY 9,0 YOu PARTICIPATE (NA CAYPAIGN CA EXELL
TIUM ANG RECTIVE A CAMPAIGN BADGE CA SEAVICE AIDBONT os

ans of explorer, date, ond reasun in each cane i
odareat ~ iB: ARE YOU A CISARLED VETERAND... crcoveee | ell
32 ALS WAS NER RELY BARRED BY THT U 3 CIVIL SERVICE COMMISSION if 00, and yau hava not hated y disability in answer ta || -—|
Pros Tass Fe JONG OR ACCEPTING CIVIL SERVICE APPOINTMENTS! . ftem 33, explain in teas 3? Lelow ty

1 your anoces ty Ul Yee.’ aive dares of and reasons for {> ARE YOU A VETERAN $ WIDOW WHO HAS NOT APMARRESD, rene cous Hl

se ftom 3?

auch goha
VRAD AS ase MeeTIC HL MaNCA Ht Gt on OTHER oisaRtuire |
Bley Sas. aa PLY Mace tites BU EO mR

{ ea hewes a Yo, gave completa adntacs oo [tem 38 30
aneneies t100n be given to yuur phy ttoal Atnesa for

a0 AA Yel Tae TA NETEPAM ANT EA A RER
DME T own deg BOREDOM ES OLN te 08 apes

. THIS SPACE FOR USE GF APPOLUTING Offi ba OLY

The information centaiaed tn (ae answers (6 Question 37 above hes een ven

By voy Sng AN MSNUITY HOM THE LwlTED PTATTS 2 OTRIT fed hy eomnpariaan with the dischatge certificnte om... 0. eee cere LDee eee
OF GRU. TOMENY UNGER ANY PUTREMENT ACT Ont ANT PEN HOU
CR OonEt Soe wes EON FOR, “MILTARY OR NAWAL SEAVILE?.,

if your * ge complate doratiain Trem 39”

Agency’
om numbers to Winch anawors wppir

smn

rary quads ee peper the same ease a3 this pase.

of thrt ar 23a Te.
Belor)e atgning thia application check back over it to make sure that you have auswered ALL questions corectly.
PCERTIFY that the satements made by me in this apphcation ace truce, complete, aml correct to the beat «f my knowledge

we ») A .

and bheuri, and are made in goed faith. -
jp Palse wotrenes? on the PB cade +» signature oF appucanT eh Reale.
panesaice by Law CU. . (Ego your ea cet INK (one ven. dal gr ipttuls, and ecrnaae). Af feroale,
Tale 73, Sectiva Sup Pecha Mies ca Mis anditmarnes we your swan geo name te “Mee Stas 1. Dee! “5
5 . :

UL.  CORGNMIAT FRIIS Corie rict-O-89297 rd


